Lactate Kinetics Reflect Organ Dysfunction and Are Associated with Adverse Outcomes in Intensive Care Unit Patients with COVID-19 Pneumonia: Preliminary Results from a GREEK Single-Centre Study

Vassiliou, Alice G.; Jahaj, Edison; Ilias, Ιoannis; Markaki, Vasiliki; Malachias, Sotirios; Vrettou, Charikleia; Ischaki, Eleni; Mastora, Zafeiria; Douka, Evangelia; Keskinidou, Chrysi; Tsipilis, Stamatios; Vassiliadi, Dimitra Argyro; Kotanidou, Anastasia; Dimopoulou, Ioanna

doi:10.3390/metabo10100386

Cited by 27 publications

(23 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To the best of our knowledge, this is the first study reporting characteristics of and outcomes from COVID-19 for patients requiring ICU admission in Egypt. Similar to previous studies from European [ 2 , 3 , 5 , 8 , 10 , 12 , [15] , [16] , [17] , [18] , 21 , 31 , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] ], North American [ 4 , 6 , 7 , [24] , [25] , [26] ], and Asian [ 11 , 19 , 20 , 23 , [27] , [28] , [29] , [30] , 44 ] ICUs, more than two-thirds of our patients were male, with a high prevalence of preexisting comorbid conditions. Nonetheless, 23% of patients in our cohort did not have known comorbid conditions, suggesting that severe SARS-Cov-2 infections with a fatal outcome may also occur in otherwise healthy individuals.…”

Section: Discussionsupporting

confidence: 91%

Outcomes and risk factors for death in patients with coronavirus disease-2019 (COVID-19) pneumonia admitted to the intensive care units of an Egyptian University Hospital. A retrospective cohort study

Nassar

Mokhtar

Elhadidy

et al. 2021

Journal of Infection and Public Health

View full text Add to dashboard Cite

Background The characteristics, outcomes, and risk factors for in-hospital death of critically ill intensive care unit (ICU) patients with coronavirus disease-2019 (COVID-19) have been described in patients from Europe, North America and China, but there are few data from COVID-19 patients in Middle Eastern countries. The aim of this study was to investigate the characteristics, outcomes, and risk factors for in-hospital death of critically ill patients with COVID-19 pneumonia admitted to the ICUs of a University Hospital in Egypt. Methods Retrospective analysis of patients with COVID-19 pneumonia admitted between April 28 and July 29, 2020 to two ICUs dedicated to the isolation and treatment of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Cairo University Hospitals. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples and radiologic evidence of pneumonia. Results Of the 177 patients admitted to the ICUs during the study period, 160 patients had COVID-19 pneumonia and were included in the analysis (mean age: 60 ± 14 years, 67.5% males); 23% of patients had no known comorbidities. The overall ICU and hospital mortality rates were both 24.4%. The ICU and hospital lengths of stay were 7 (25–75% interquartile range: 4–10) and 10 (25–75% interquartile range: 7–14) days, respectively. In a multivariable analysis with in-hospital death as the dependent variable, ischemic heart disease, history of smoking, and secondary bacterial pneumonia were independently associated with a higher risk of in-hospital death, whereas greater PaO 2 /FiO 2 ratio on admission to the ICU was associated with a lower risk. Conclusion In this cohort of critically ill patients with COVID-19 pneumonia, ischemic heart disease, history of smoking, and secondary bacterial pneumonia were independently associated with a higher risk of in-hospital death.

show abstract

Section: Discussionsupporting

confidence: 91%

Outcomes and risk factors for death in patients with coronavirus disease-2019 (COVID-19) pneumonia admitted to the intensive care units of an Egyptian University Hospital. A retrospective cohort study

Nassar

Mokhtar

Elhadidy

et al. 2021

Journal of Infection and Public Health

View full text Add to dashboard Cite

show abstract

“…In total, 6498 abstracts were screened, with 751 full‐text reviews. Fifty‐eight studies with 44,305 patients were included in the review [2, 8‐65]. These included studies provided data on mortality or survival following ICU admission for 43,845 (99.0%) of the patients.…”

Section: Resultsmentioning

confidence: 99%

Factors associated with mortality in patients with COVID‐19 admitted to intensive care: a systematic review and meta‐analysis

et al. 2021

View full text Add to dashboard Cite

Summary Identification of high‐risk patients admitted to intensive care with COVID‐19 may inform management strategies. The objective of this meta‐analysis was to determine factors associated with mortality among adults with COVID‐19 admitted to intensive care by searching databases for studies published between 1 January 2020 and 6 December 2020. Observational studies of COVID‐19 adults admitted to critical care were included. Studies of mixed cohorts and intensive care cohorts restricted to a specific patient sub‐group were excluded. Dichotomous variables were reported with pooled OR and 95%CI, and continuous variables with pooled standardised mean difference (SMD) and 95%CI. Fifty‐eight studies (44,305 patients) were included in the review. Increasing age (SMD 0.65, 95%CI 0.53–0.77); smoking (OR 1.40, 95%CI 1.03–1.90); hypertension (OR 1.54, 95%CI 1.29–1.85); diabetes (OR 1.41, 95%CI 1.22–1.63); cardiovascular disease (OR 1.91, 95%CI 1.52–2.38); respiratory disease (OR 1.75, 95%CI 1.33–2.31); renal disease (OR 2.39, 95%CI 1.68–3.40); and malignancy (OR 1.81, 95%CI 1.30–2.52) were associated with mortality. A higher sequential organ failure assessment score (SMD 0.86, 95%CI 0.63–1.10) and acute physiology and chronic health evaluation‐2 score (SMD 0.89, 95%CI 0.65–1.13); a lower PaO2:FIO2 (SMD −0.44, 95%CI −0.62 to −0.26) and the need for mechanical ventilation at admission (OR 2.53, 95%CI 1.90–3.37) were associated with mortality. Higher white cell counts (SMD 0.37, 95%CI 0.22–0.51); neutrophils (SMD 0.42, 95%CI 0.19–0.64); D‐dimers (SMD 0.56, 95%CI 0.43–0.69); ferritin (SMD 0.32, 95%CI 0.19–0.45); lower platelet (SMD −0.22, 95%CI −0.35 to −0.10); and lymphocyte counts (SMD −0.37, 95%CI −0.54 to −0.19) were all associated with mortality. In conclusion, increasing age, pre‐existing comorbidities, severity of illness based on validated scoring systems, and the host response to the disease were associated with mortality; while male sex and increasing BMI were not. These factors have prognostic relevance for patients admitted to intensive care with COVID‐19.

show abstract

“…A recent study measured blood lactate levels on ICU admission and thereafter daily up to 14 th day in 45 patients with confirmed COVID‐19 pneumonia. Based on 28‐day ICU mortality rates, mean daily lactate levels were higher in nonsurvivors, and initial blood lactate was proposed as an independent outcome predictor in ICU‐admitted COVID‐19 patients 29 …”

Section: Discussionmentioning

confidence: 99%

The boundaries between survival and nonsurvival at COVID‐19: Experience of tertiary care pandemic hospital

Arslan¹,

Doğan²,

Öcal³

et al. 2021

Int J Clin Pract

View full text Add to dashboard Cite

Objective Coronavirus disease 2019 (COVID‐19) is an emerging, fast‐spreading, highly mortal and worldwide infectious disease. The pulmonary system was defined as the main target of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), but the mortality concept of this disease presented with more severe and systemic disease. The present study investigated the relationship between the patient characteristics at the initial hospital administration and fatality in COVID‐19 patients. Methods In this retrospective and comparative cohort study, all the 767 hospitalised COVID‐19 patients, treated between 18 March and 15 May 2020 in the Covid Clinics of Gulhane Training and Research Hospital in Ankara, Turkey, were evaluated. Results The fatality rate was significantly increased in patients with any comorbid disease except asthma. The initial laboratory test results indicated highly significant differences according to the patient's outcome. A multifactor logistic regression analysis was performed to calculate the adjusted odds ratios for predicting patient outcomes. Being older than 60 years increased the death risk with an adjusted OR of 7.2 (95% CI: 2.23‐23.51; P = .001). The presence of a cancer and the extended duration of intensive care unit treatment were other significant risk factors for nonsurvival. Azithromycin treatment was determined as significantly reduced the death ratio in these patients ( P = .002). Conclusion It was revealed that being older than 60 years, presence of a cancer and extended duration of ICU treatment were the major risk factors for predicting fatality rate in hospitalised COVID‐19 patients.

show abstract

Lactate Kinetics Reflect Organ Dysfunction and Are Associated with Adverse Outcomes in Intensive Care Unit Patients with COVID-19 Pneumonia: Preliminary Results from a GREEK Single-Centre Study

Cited by 27 publications

References 30 publications

Outcomes and risk factors for death in patients with coronavirus disease-2019 (COVID-19) pneumonia admitted to the intensive care units of an Egyptian University Hospital. A retrospective cohort study

Outcomes and risk factors for death in patients with coronavirus disease-2019 (COVID-19) pneumonia admitted to the intensive care units of an Egyptian University Hospital. A retrospective cohort study

Factors associated with mortality in patients with COVID‐19 admitted to intensive care: a systematic review and meta‐analysis

The boundaries between survival and nonsurvival at COVID‐19: Experience of tertiary care pandemic hospital

Contact Info

Product

Resources

About