Factors Associated With Intubation and Prolonged Intubation in Hospitalized Patients With COVID‐19

Hur, Kevin; Price, Caroline P.E.; Gray, Elizabeth; Gulati, Reeti K.; Maksimoski, Matthew; Racette, Samuel D.; Schneider, Alexander L.; Khanwalkar, Ashoke

doi:10.1177/0194599820929640

Cited by 161 publications

(176 citation statements)

References 34 publications

(98 reference statements)

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“…This finding coincides with an earlier study on a similar population [6]. A high mortality rate was also seen in the invasively ventilated patients (82%) in our study which is much higher than what has been reported in Italy (23.3%) and the United States of America (15.2%) [9,10].…”

Section: Discussionsupporting

confidence: 91%

“…A study conducted by Hur, et al found that the median age of their intubated patients was higher than the median age of patients that did not require intubation (65 vs 57 years). Age was a significant factor in determining whether the patients required invasive ventilation or not [9]. Our results showed that 67.3% of intubated patients were in the age range of 50-75 years (with a mean age of 56.46 ± 13.78), however, the age of patients on non-invasive was not significantly different from those on invasive ventilation.…”

Section: Discussionmentioning

confidence: 55%

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Role of Biochemical Markers in Invasive Ventilation of Coronavirus Disease 2019 Patients: Multinomial Regression and Survival Analysis

Asghar¹,

Kazmi²,

Khan³

et al. 2020

Cureus

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Background and objectives Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic. The disease mainly affects the respiratory system of the patient, in particular, the lungs, which leads to patients presenting with acute respiratory distress syndrome and acute respiratory failure, with 5-15% of patients requiring observation in the intensive care unit (ICU) with respiratory support in the form of ventilation. This study was aimed at identifying the role of biochemical markers in the risk stratification of invasive and non-invasive ventilation of hospitalized COVID-19 patients. Materials and methods The study was conducted as a prospective, observational study of all admitted COVID-19 patients. A comparative analysis was performed of the survivors who were on invasive versus (vs) non-invasive ventilation and the non-survivors similarly. After computing the descriptive statistics, a multinomial logistic regression model was applied to obtain an unadjusted odds ratio (OR) at 95% confidence interval (CI), with Hosmer-Lemeshow (HL) goodness-of-fit test used to predict the fitness of the data. Kaplan-Meier survival curves were obtained for each of the laboratory investigations predicting survival along with the intensive care stay and invasive ventilation. A log-rank test was carried out to compare the survival distributions. Results A total of 373 included patients in the study had a mean age of 52.78 ± 15.76 years with females younger than males, and indifference amongst invasive vs non-invasively ventilated (p=0.821). Females were slightly more prone to invasive ventilation (p=0.097). Overall, 39% of the subjects did not need respiratory support, while 13% were on a ventilator, 16% on bilevel positive airway pressure/continuous positive airway pressure (BiPAP/CPAP), and 31% on supplemental oxygen therapy. Among the laboratory markers, mean hemoglobin was evidently lower in the invasive group, leukocytosis and thrombocytopenia were present in both invasively ventilated and non-surviving patients, while neutrophilia and lymphocytopenia were statistically indifferent among the mode of ventilation. Elevated urea, creatinine, and sodium were also significantly deranged laboratory markers amongst the invasively ventilated group. C-reactive protein (CRP) and lactate dehydrogenase (LDH) were elevated significantly in the invasive group, while serum ferritin was more frequently raised in the non-invasively ventilated group. Procalcitonin (PCT) was significantly associated with invasive ventilation as opposed to the non-invasive group. D-dimer was equally raised in both the groups at admission but significantly elevated in the invasive group at discharge. A multinomial regression model signified D-dimer (

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 55%

Role of Biochemical Markers in Invasive Ventilation of Coronavirus Disease 2019 Patients: Multinomial Regression and Survival Analysis

Asghar¹,

Kazmi²,

Khan³

et al. 2020

Cureus

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“…The copyright holder for this this version posted September 23, 2020. ; https://doi.org/10.1101/2020.09. 22…”

Section: Figure A3 Smoking and Covid-19 Mortalitymentioning

confidence: 99%

“…The greater effect of smoking among young people is particularly important because in the U.S., almost 40% of COVID-19 patients are aged lower than 13.7% (15.6% for men and 12.0% for women) smoking prevalence in 2018[68]. The other 4 studies[8,22, 25, 33] in the U.S. reported the ever-smoking prevalence ranged from 13.3%-33.5%, which was also lower than 41.9% (47.2% for men and 37.3% for…”

mentioning

confidence: 99%

Smoking is associated with worse outcomes of COVID-19 particularly among younger adults: A systematic review and meta-analysis

Patanavanich

Glantz

2020

Preprint

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Background: Smoking impairs lung immune functions and damages upper airways, increasing risks of contracting and severity of infectious diseases. Methods: We searched PubMed and Embase for studies published from January 1-May 25, 2020. We included studies reporting smoking behavior of COVID-19 patients and progression of disease, including death. We used a random effects meta-analysis and used meta-regression and lowess regressions to examine relationships in the data. Results: We identified 47 peer-reviewed papers with a total of 31,871 COVID-19 patients, 5,759 (18.1%) experienced disease progression and 5,734 (18.0%) with a history of smoking. Among smokers, 29.2% experienced disease progression, compared with 21.1% of non-smokers. The meta-analysis confirmed an association between smoking and COVID-19 progression (OR 1.56, 95% CI 1.32-1.83, p=0.001). Smoking was associated with increased risk of death from COVID-19 (OR 1.19, 95% CI 1.05-1.34, p=0.007). We found no significant difference (p=0.432) between the effects of smoking on COVID-19 disease progression between adjusted and unadjusted analyses, suggesting that smoking is an independent risk factor for COVID-19 disease progression. We also found the risk of having COVID-19 progression among younger adults (p=0.023), with the effect most pronounced among people under about 45 years old. Conclusions: Smoking is an independent risk for having severe progression of COVID-19, including mortality. The effects seem to be higher among young people. Smoking prevention and cessation should remain a priority for the public, physicians, and public health professionals during the COVID-19 pandemic.

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“…There was no conclusive overlap, but the review team identified 29 studies [22-24, 26-28, 30, 31, 33, 34, 36-38, 44-57, 59, 61] that could potentially overlap (details in Table of potentially overlapping study populations (Supple-mentary Material 1, www.jofem.org)). Removing these studies from the analysis, the primary objective was analyzed using only the six remaining eligible studies [2,29,35,41,58,62]. The pooled measure of association from four studies [2,35,41,58] was an adjusted odds ratio of 1.88 (95% CI 1.29 -2.74), and the pooled measure of association from two studies [29,62] was an adjusted hazard ratio of 1.67 (95% CI 1.32 -2.10) (Supplementary Material 1, www.jofem.org).…”

Section: Resultsmentioning

confidence: 99%

Association of Diabetes and Severe COVID-19 Outcomes: A Rapid Review and Meta-Analysis

Kubjane

McCreedy²,

Cariou

et al. 2020

J Endocrinol Metab

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Background: Addressing the urgent need for evidence on diabetes as a serious comorbidity for severe illness and death from coronavirus disease 2019 (COVID-19), we investigated the association between diabetes and COVID-19 disease severity in patients hospitalized due to COVID-19. Methods: This rapid review and meta-analysis was undertaken in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE and EMBASE were searched for studies published between January 1 and May 20, 2020. Studies included were English language, peer-reviewed, observational studies of adults hospitalized for COVID-19 with reported clinical course and living with or without diabetes. The severity of clinical course was assessed using a composite outcome (mortality, admittance to intensive care unit (ICU), requirement for invasive mechanical ventilation (IMV), clinically defined severe or critical disease). Data and adjusted measures of association were extracted from published reports, and meta-analysis was performed using a random effects model. The protocol was registered with OSF (https://osf.io/agsyb/). Results: A literature search yielded 431 articles, of which 45 studies (22,091 patients) met the inclusion criteria and 14 studies (12,383 patients) reported an adjusted measure of association for diabetes with the composite outcome with pooled hazard ratio 1.59 (95% confidence interval 1.3-1.93; I 2 = 0%, P = 0.820) and pooled odds ratio of 2.15 (95% confidence interval 1.63-2.83; I 2 = 0%, P = 0.892); evidence by GRADE was moderate. Conclusions: People living with diabetes are more likely to develop severe COVID-19 clinical course if hospitalized for COVID-19 than people not living with diabetes. To inform clinical decision-making during the pandemic, our findings support that people living with diabetes who are hospitalized for COVID-19 should be prioritized when triaged as at increased risk for the development of severe clinical course.

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Factors Associated With Intubation and Prolonged Intubation in Hospitalized Patients With COVID‐19

Cited by 161 publications

References 34 publications

Role of Biochemical Markers in Invasive Ventilation of Coronavirus Disease 2019 Patients: Multinomial Regression and Survival Analysis

Role of Biochemical Markers in Invasive Ventilation of Coronavirus Disease 2019 Patients: Multinomial Regression and Survival Analysis

Smoking is associated with worse outcomes of COVID-19 particularly among younger adults: A systematic review and meta-analysis

Association of Diabetes and Severe COVID-19 Outcomes: A Rapid Review and Meta-Analysis

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