Factors associated with progression to critical illness in 28 days among COVID-19 patients: results from a tertiary care hospital in Istanbul, Turkey

Sili, Uluhan; Ay, Pınar; Topuzoğlu, Ahmet; Bilgin, Hüseyin; Tigen, Elif Tukenmez; Şengel, Buket Ertürk; Çağlayık, Dilek Yağcı; Balcan, Baran; Kocakaya, Derya; Yıldızeli, Şehnaz Olgun; Gül, Fethi; Bilgili, Beliz; Sarınoğlu, Rabia Can; Yağcı, Ayşegül; Durmusoglu, Lutfiye Mulazimoglu; Eryüksel, Emel; Odabaşı, Zekaver; Direşkeneli, Haner; Karakurt, Sait; Cinel, İsmail; Korten, Volkan

doi:10.1101/2020.10.09.20209775

Cited by 4 publications

(4 citation statements)

References 24 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the primary target of our study was to describe the serum concentration–time profile and pharmacokinetic features of favipiravir, follow‐up of the laboratory parameters of the COVID‐19 patients indicated a significant increase in ferritin levels in the deceased patients, whereas there was a significant decrease in D‐dimer and C‐reactive protein levels in the surviving patients at Day 0 compared to Day 5. In previous studies, COVID‐19 patients with elevated inflammatory markers have been reported to have worse prognosis of disease and our results are compatible with such findings in the literature 10,18,23,25,26 . A recent observation indicated a hyper‐inflammatory state in COVID‐19, which is related to hyperdynamic state with high cardiac output and increased renal perfusion due to vasodilatation, which results in augmented renal clearance and speeds the elimination of renally cleared drugs 19,27 .…”

Section: Discussionsupporting

confidence: 90%

“…In previous studies, COVID-19 patients with elevated inflammatory markers have been reported to have worse prognosis of disease and our results are compatible with such findings in the literature. 10,18,23,25,26 A recent observation indicated a hyperinflammatory state in COVID-19, which is related to hyperdynamic state with high cardiac output and increased renal perfusion due to vasodilatation, which results in augmented renal clearance and speeds the elimination of renally cleared drugs. 19,27 Therefore, monitoring drug concentration of renally eliminated drugs can be advised in critically ill COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pharmacokinetic characterization of favipiravir in patients with COVID‐19

Aker

Eryüksel

Oğlu

et al. 2022

Brit J Clinical Pharma

Self Cite

View full text Add to dashboard Cite

This prospective observational study describes the pharmacokinetic characteristics of favipiravir in adult patients hospitalized for mild to moderate COVID‐19 with a positive RT‐PCR test. Favipiravir was administered for 5 days, with a loading dose of 3200 mg and a maintenance dose of 1200 mg/day. Serial blood samples were collected on Day 2 and Day 4 of the therapy. Laboratory findings of the patients (n = 21) and in‐hospital mortality were recorded. Favipiravir concentrations exhibited substantial variability and a significant decrease during the treatment of COVID‐19. The median favipiravir trough concentration (C0‐trough) on Day 2 was 21.26 (interquartile range [IQR], 8.37–30.78) μg/mL, whereas it decreased significantly to 1.61 (IQR, 0.00–6.41) μg/mL on Day 4, the area under the concentration–time curve decreased by 68.5%. Day 2 C0‐trough of female patients was higher than male patients. Our findings indicate that favipiravir concentrations show significant variability during the treatment of COVID‐19 and therapeutic drug monitoring may be necessary to maintain targeted concentrations.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Pharmacokinetic characterization of favipiravir in patients with COVID‐19

Aker

Eryüksel

Oğlu

et al. 2022

Brit J Clinical Pharma

Self Cite

View full text Add to dashboard Cite

show abstract

“…Compared with survivors, non-survivors had lower DBP (78.0 vs. 70.0; p=0.0039), lower sO2 (93.0 vs. 87.5; p<0.0001), and higher RR (28.0 vs. 36.0; p=0.0002). In another study conducted in our instutituon, body temperature ≥38°C, RR ≥22/min, and sO2 ≤93% were revealed to be related with progression to critical illness among COVID-19 patients [ 16 ]. In our study, we recorded the variables as continuous variables instead of categoric, contrary to the study mentioned above.…”

Section: Discussionmentioning

confidence: 99%

Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department

Saçak¹,

Karacabey²,

Sanri³

et al. 2021

Cureus

View full text Add to dashboard Cite

Introduction: A cluster of atypical pneumonia cases in Wuhan, China, turned out to be a highly contagious disease, swept across most of the countries, and soon after was announced as a pandemic. Therefore we aimed to investigate the demographics and factors associated with the disease outcome. Methods: In this retrospective chart review, we screened patients admitted to the emergency department with severe acute respiratory infection due to coronavirus disease 2019 (COVID-19) between March 15, 2020 and April 30, 2020. Age, gender, symptoms, laboratory data, and radiology data were obtained, as well as outcomes and length of stay. Results: We identified 177 patients (54.8% male). Seventy-eight percent of the cases were admitted into wards whereas 22% of the cases were admitted into the intensive care unit (ICU). Twenty-five percent of the cases needed invasive mechanical ventilation during their hospital stay and median length of hospital stay until death or discharge was eight days (interquartile range (IQR) 5.0 - 16.0). Among 177 patients, overall in-hospital mortality rate was 19.8% (n=35; male:female=18:17; p=0.6553). In-hospital mortality rates were statistically significantly higher in patients with higher age (64 vs. 74; p=0.0091), respiratory rate (RR) (28 vs. 36; p=0.0002), C-reactive protein (CRP) (54.7 vs. 104.0; p<0.0001), d-dimer (1.2 vs. 3.2; p<0.0001), ferritin (170 vs. 450.4; p<0.0001), fibrinogen (512 vs. 598; p=0.0349), international normalized ratio (INR) (1.1 vs. 1.3; p=0.0001), prothrombin time (PT) (14.8 vs. 17.4; p=0.0001), procalcitonin (0.1 vs. 0.3; p<0.0001), creatinine (0.9 vs. 1.1; p=0.0084), longer length of stay (LOS) (8.0 vs. 13.0; p=0.0251) with lower oxygen saturation (sO 2 ) (93.0% vs 87.5%; p<0.0001), diastolic blood pressure (DBP) (78 vs. 70; p=0.0039), lymphocyte (1.2 vs. 0.8; p=0.0136), and with positive polymerase chain reaction (PCR) results (28.6% vs. 12.8%; p=0.0118). Conclusion: Patients with older age, higher RR, lower sO 2 and DBP, higher creatinine, d-dimer, INR, CRP, procalcitonin, ferritin, and fibrinogen on initial admission were found to be less likely to survive COVID-19.

show abstract

“…Döngü eşik değeri; yüksek (<20), orta (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) ve düşük (>30) olarak kategorize edildi. Yatan hasta kohortuna ait veriler ayrı bir çalışma yapılarak yayımlandı (17). Çalışmadaki bağımsız değişkenler, yukarıda sözü edilen standart formdaki kayıtlı verilerden elde edildi.…”

Section: Yöntemlerunclassified

The Incidence and Factors Affecting the 28-day Hospital Admission Among Adult Ambulatory COVID-19 Patients

Bilgin,

Topuzoglu,

Sili

et al. 2023

Klimik Derg

View full text Add to dashboard Cite

Objective: This study aimed to determine the 28-day hospital admission incidence and risk factors related to the hospitalization of COVID-19 patients who were followed as outpatients in a university hospital. Methods: A retrospective cohort study was designed in which the sociodemographic characteristics, symptoms on the first visit, presence of comorbidities, and viral load predictor cycle threshold (Ct) value were defined as independent variables and hospital admission in the first 28 days after the first visit was defined as dependent variable. Factors related to hospital admission were evaluated with univariate and multivariate analyses. Cox regression analysis was used for multivariate analyses, and the effect size was determined with a hazard ratio (HR). Statistical significance was defined as p<0.05. Results: 368 patients were included in this study. The median (25-75th percentile) age was 36 (28-45) years, and 46.1% of the patients were female. Sixty-five patients (17.7%) were hospitalized in the first 28 days. When age ≤29 referenced, age≥50 (HR=4.1, 95% confidence interval [CI]=1.7-9.6), 40-49 (HR=3.0, 95% CI=1.3-6.6) and 30-39 (HR=1.6, 95% CI=0.6-3.6), fever or chills, (HR=2.3, 95% CI=1.3-4.1), dyspnea (HR=2.0, 95% CI=1.1-3.4), fatigue (HR=1.9, 95% CI=1.0-3.5), vomiting (HR=3.0, 95% CI=1.5-5.8), and sore throat (HR=0.4, 95% CI=0.2-0.8) were defined as independent risk factors according to multivariable analysis. Hypertension was the only comorbidity independently predicting hospital admission (HR=2.2, 95% CI=1.0-4.4). Conclusion: Advanced age, systemic and lower respiratory tract infection signs, and hypertension independently increased the 28-day hospital admission. The presence of a sore throat was not a factor for hospital admission. A lower risk of hospital admission in patients with sore throats may indicate that the patient will have a mild upper respiratory tract infection and will not progress to severe disease. Due to missing data, this study could not fully evaluate the hospital admission risk factors. Studies that include clinical, laboratory, and radiological findings are needed to generate a more accurate model predicting hospital admission risk.

show abstract

Factors associated with progression to critical illness in 28 days among COVID-19 patients: results from a tertiary care hospital in Istanbul, Turkey

Cited by 4 publications

References 24 publications

Pharmacokinetic characterization of favipiravir in patients with COVID‐19

Pharmacokinetic characterization of favipiravir in patients with COVID‐19

Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department

The Incidence and Factors Affecting the 28-day Hospital Admission Among Adult Ambulatory COVID-19 Patients

Contact Info

Product

Resources

About