Outcomes in Patients With COVID-19 Disease and High Oxygen Requirements

Abstract

Background Approximately 19% of people infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) progress to severe or critical stages of the coronavirus disease 2019 (COVID-19) with a mortality rate exceeding 50%. We aimed to examine the characteristics, mortality rates, intubation rate, and length of stay (LOS) of patients hospitalized with COVID-19 disease with high oxygen requirements (critically ill). Methods We conducted a retrospective analysis in a single center in Brooklyn, New York. Adult hospitalized patients with confirmed COVID-19 disease and high oxygen requirements were included. We performed multivariate logistic regression analyses for statistically significant variables to reduce any confounding. Results A total of 398 patients were identified between March 19th and April 25th, 2020 who met the inclusion criteria, of which 247 (62.1%) required intubation. The overall mortality rate in our study was 57.3% (n = 228). The mean hospital LOS was 19.1 ± 17.4 days. Patients who survived to hospital discharge had a longer mean LOS compared to those who died during hospitalization (25.4 ± 22.03 days versus10.7 ± 1.74 days). In the multivariate analysis, increased age, intubation and increased lactate dehydrogenase (LDH) were each independently associated with increased odds of mortality. Diarrhea was associated with decreased mortality (OR 0.4; CI 0.16, 0.99). Obesity and use of vasopressors were each independently associated with increased intubation. Conclusions In patients with COVID-19 disease and high oxygen requirements, advanced age, intubation, and higher LDH levels were associated with increased mortality, while diarrhea was associated with decreased mortality. Gender, diabetes, and hypertension did not have any association with mortality or length of hospital stay.

High triglyceride to HDL-cholesterol ratio as a biochemical marker of severe outcomes in COVID-19 patients

“…Elevated Tg and low HDL c were constantly associated with clinical and biochemical data of COVID-19 severity like increased LDH levels which is an inflammatory marker previously proposed as predictor of poor prognosis in COVID-19 patients [20,21] and with NEWS 2 an early warning score published by the Royal College of Physicians [22] with a good performance in the prediction of severity and mortality in COVID- 19 patients [22e24]. A low HDL c concentration was additionally linked with high ferritin levels, a protein associated with inflammatory processes and previously reported increased in severe COVID-19 patients [25], related with SARS-CoV-2 viremia [18] and proposed as predictor of mortality for the disease [26,27].…”

Assessment of Six-Minute Walk Test Among Discharge-Ready Severe COVID-19 Patients: A Cross-Sectional Study

“…A similar finding was not reproducible with other studied markers, i.e., CRP and IL-6. LDH is an established marker of severe COVID-19 pneumonia [ 19 , 20 ]. The rise of serum LDH in patients with severe illness is attributable to three mechanisms.…”

Characteristics, outcomes and global trends of respiratory support in patients hospitalized with COVID-19 pneumonia: a scoping review

“…PaCO2 at admission was available in nine studies 19,24,27,[29][30][31]33,35,42 (17%), and median PaCO2 values ranged from 33 mmHg 19,33 to 42 mmHg 30 (Supplementary Digital Material 1: Supplementary Table 2). Respiratory rate at admission was reported in 21 studies 19,23,25,27,28,30,32,33,35,36,39,40,45,47,[56][57][58]60,62,70 (40.4%), and generally ranged from 18-20 breaths/min 28,45,56,60 to 27-28 breaths/min 25,35 .…”

“…The median PaO2/FiO2 at admission ranged from 60 mmHg 44 to 442 mmHg 32 . Data on SpO2 and PaO2 were reported respectively in 14 19,23,27,28,[34][35][36]40,45,47,[56][57][58]61,70 (27%) and seven studies 7,19,27,29,30,35,42 (13%). PaCO2 at admission was available in nine studies 19,24,27,[29][30][31]33,35,42 (17%), and median PaCO2 values ranged from 33 mmHg 19,33 to 42 mmHg 30 (Supplementary Digital Material 1: Supplementary Table 2).…”