Clinical Characteristics of Critically Ill Patients Infected with COVID-19 in Rasoul Akram Hospital in Iran: A Single Center Study

Rahimzadeh, Poupak; Amniati, Saied; Farahmandrad, Reza; Faiz, Seyed Hamid Reza; Emami, Setareh Hedayati; Habibi, Azadeh

doi:10.5812/aapm.107211

Cited by 10 publications

(8 citation statements)

References 20 publications

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“…Previous studies reported a wide range of mortality rates among critically ill patients admitted to ICU, from 16% to 38%, 62%, 67%, and 80% (12)(13)(14)(15)(22)(23)(24). In our study, overall outcomes were poor in severe patients who received ICU care, and the mortality rate (84.6%) was considerably higher than other studies.…”

Section: Discussioncontrasting

confidence: 60%

Clinical Features and Prognosis of Invasive Ventilation in Hospitalized Patients with COVID-19: A Retrospective Study

et al. 2020

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Background: World Health Organization (WHO) declared that the outbreak of COVID-19 constituted a public health emergency of global concern. Objectives: Owing to limited data on critically ill patients admitted to ICU, we aimed to describe the clinical characteristics and prognosis of these patients based on ventilatory variables and clinical features. Methods: In this retrospective study, 45 critically ill patients with laboratory-confirmed COVID-19 who were admitted to Intensive Care Unit (ICU) wards of the hospital from April 8 to May 9, 2020, were enrolled. Medical files of the patients were reviewed, and demographic and clinical characteristics, laboratory data, lung CT scan findings, causes of intubation, and outcomes of the patients were all collected. Results: The median age of the patients was 67 years (range 22 to 91), 64% were men, and hypertension was the most common comorbidity. History of close contact with previously confirmed patients was positive in 62.2% of the patients. The mean time from symptom onset to hospital admission was 5.98 ± 2.93 days. The most common symptoms at the onset of illness were dyspnea (95.6%), and gastrointestinal symptoms (22.2%) were rare. The average length of the intubation was 4.84 ± 3.28 days. The distribution of intubation causes in the deceased patients was significantly more than the recovered patients (P = 0.031). The mean score of lung CT involvement in deaths (370.26 ± 207.50) was significantly higher than the recovered patients (235.71 ± 81.21) (P = 0.042). Length of the intubation had a statistically direct correlation with respiratory rate (P = 0.03). Conclusions: Most of the critically ill patients admitted to ICU were older men and had poor outcomes with a high mortality rate. Furthermore, the score of chest CT involvement and respiratory rate are important prognostic factors in determining the severity of the illness, requiring ventilatory support, and outcome.

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Section: Discussioncontrasting

confidence: 60%

Clinical Features and Prognosis of Invasive Ventilation in Hospitalized Patients with COVID-19: A Retrospective Study

et al. 2020

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“…been conducted globally to discover a feasible, effective treatment. Unfortunately, critically ill and mechanically ventilated patients suffering COVID-19 show an overall higher mortality rate (10)(11)(12). Although vaccine development offers a glimmer of hope to end the current appalling pandemic, there is still a lack of definitive therapy, particularly for SARS-CoV-2-induced pneumonia (13).…”

Section: Contextmentioning

confidence: 99%

An Umbrella Review of Clinical Efficacy and Adverse Cardiac Events Associated with Hydroxychloroquine or Chloroquine with or Without Azithromycin in Patients with COVID-19

et al. 2021

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Context: The safety and efficacy of several repurposed drugs, including hydroxychloroquine and chloroquine, with or without azithromycin, were presumed to be miraculous in treating patients with COVID-19. However, as it later transpired, these therapeutic agents seem to be associated with critical adverse cardiac events. Objectives: Given the skepticism around the advantages and disadvantages of the aforementioned treatment strategies, the present study aimed to investigate the clinical efficacy and cardiac toxicity of hydroxychloroquine or chloroquine with or without azithromycin in the setting of COVID-19 infection. Method: This was an umbrella review conducted on patients with COVID-19 who received hydroxychloroquine or chloroquine with or without azithromycin from January 2020 to November 2020. We systematically searched PubMed, Scopus, Cochrane, ProQuest, Web of Science, and Embase databases. Results: Three studies (systematic review and meta-analysis) were analyzed to evaluate the arrhythmogenic potential of hydroxychloroquine or chloroquine with or without azithromycin in patients with COVID-19 and identify the clinical efficacy of such a combination. Conclusions: We found no benefit for patients with COVID-19 who received hydroxychloroquine or chloroquine alone or in combination with azithromycin. Moreover, it is noteworthy that these medications, particularly when considering co-administration, could result in both statistically and clinically elevated risks of notorious arrhythmias, such as TdP.

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“…are at higher risk of death (11). Moreover, in the middle of a pandemic, health care systems face various challenges of which limited availability of resources is important because this limitation can impose a lot of stress on healthcare workers (12).…”

Section: Introductionmentioning

confidence: 99%

“…According to a review article, 14 - 32% of infected patients develop a critical illness, and 29-89% of patients with COVID-19 require mechanical ventilation support ( 10 ). Although critically ill patients with COVID-19 are not the majority of cases, they require more sophisticated care and are at higher risk of death ( 11 ). Moreover, in the middle of a pandemic, health care systems face various challenges of which limited availability of resources is important because this limitation can impose a lot of stress on healthcare workers ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Predicting Risk Score for Mechanical Ventilation in Hospitalized Adult Patients Suffering from COVID-19

et al. 2021

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Background: COVID-19 has become a pandemic since December 2019, causing millions of deaths worldwide. It has a wide spectrum of severity, ranging from mild infection to severe illness requiring mechanical ventilation. In the middle of a pandemic, when medical resources (including mechanical ventilators) are scarce, there should be a scoring system to provide the clinicians with the information needed for clinical decision-making and resource allocation. Objectives: This study aimed to develop a scoring system based on the data obtained on admission, to predict the need for mechanical ventilation in COVID-19 patients. Methods: This study included COVID-19 patients admitted to Sina Hospital, Tehran University of Medical Sciences from February 20 to May 29, 2020. Patients' data on admission were retrospectively recruited from Sina Hospital COVID-19 Registry (SHCo-19R). Multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were performed to identify the predictive factors for mechanical ventilation. Results: A total of 681 patients were included in the study; 74 patients (10.9%) needed mechanical ventilation during hospitalization, while 607 (89.1%) did not. Multivariate logistic analysis revealed that age (OR,1.049; 95% CI:1.008-1.09), history of diabetes mellitus (OR,3.216; 95% CI:1.134-9.120), respiratory rate (OR,1.051; 95% CI:1.005-1.100), oxygen saturation (OR,0.928; 95% CI:0.872-0.989), CRP (OR,1.013; 95% CI:1.001-1.024) and bicarbonate level (OR,0.886; 95% CI:0.790-0.995) were risk factors for mechanical ventilation during hospitalization. Conclusions: A risk score has been developed based on the available data within the first hours of hospital admission to predict the need for mechanical ventilation. This risk score should be further validated to determine its applicability in other populations.

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Clinical Characteristics of Critically Ill Patients Infected with COVID-19 in Rasoul Akram Hospital in Iran: A Single Center Study

Cited by 10 publications

References 20 publications

Clinical Features and Prognosis of Invasive Ventilation in Hospitalized Patients with COVID-19: A Retrospective Study

Clinical Features and Prognosis of Invasive Ventilation in Hospitalized Patients with COVID-19: A Retrospective Study

An Umbrella Review of Clinical Efficacy and Adverse Cardiac Events Associated with Hydroxychloroquine or Chloroquine with or Without Azithromycin in Patients with COVID-19

Predicting Risk Score for Mechanical Ventilation in Hospitalized Adult Patients Suffering from COVID-19

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