Risk factors and outcomes for acute respiratory failure in coronavirus disease 2019: An observational cohort study

Abstract

Background. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread throughout Europe. However, there is a lack of data on the full clinical course of patients infected with SARS-CoV-2 in Europe, especially in the population that developed acute respiratory failure (ARF).Objectives. To identify risk factors associated with developing ARF during SARS-CoV-2 infection. Materials and methods.This was an observational study of 60 adult patients with laboratory-confirmed SARS-CoV-2 infection. Data were collected from March 26, 2020 to May 26, 2020 in a tertiary academic hospital in Poland. All patients reached final outcome (discharge from the hospital or death). We divided patients into 2 groups based on whether they developed ARF, compared their clinical data, and performed multivariate logistic regression.Results. Twenty-two patients (36%) from the observed cohort developed ARF. Logistic regression identified that a high sequential organ failure assessment score at admission (odds ratio (OR) = 6.97 (1.57-30.90, p = 0.011)), and a long time from admission until pneumonia (OR = 1.41 (1.06-1.87, p = 0.016)), correlated with ARF development. D-dimer, lactate dehydrogenase, neutrophil to lymphocyte ratio, C-reactive protein (CRP), and interleukin 6 (IL-6) differed both statistically and clinically between ARF and non-ARF groups. The mortality rate in the observed cohort of patients was 13.3%, and it was 32% in the group that developed ARF. Conclusions.Routine vigilant examination of the above markers may identify patients at the highest risk of ARF early on during COVID-19 infection.

Treatment outcomes in Polish COVID-19 patients requiring hospitalisation in the intensive care unit: a single-centre retrospective study

“…High mortality observed in the second study may be associated with delayed intubation due to the use of HFNOT, as compared to passive oxygen therapy. Another Polish observational study revealed that mortality among patients with acute respiratory failure and baseline oxygenation index ≤ 300 mmHg was 32%; however, mortality in a subgroup of patients requiring invasive mechanical ventilation reached 66.7% and was markedly higher compared to our cohort [9]. Unfortunately, the lack of detailed data on patients transferred to the ICU makes it impossible to confirm a relationship between the clinical characteristics of patients and treatment outcomes.…”

Neutrophils and COVID-19: Active Participants and Rational Therapeutic Targets

“…An increased NLR at hospital admission is emerging as a useful indicator of disease severity and a potential tool of diagnostic and prognostic utility (106,107). For example, significantly higher baseline NLR values have been measured in COVID-19 patients who develop severe/critical disease when compared to mild or moderate cases (51,90,92,95,(108)(109)(110)(111), with this elevation persisting for up to 15 days post-hospital admission (51,100,112). In terms of its discriminatory power, NLR has been shown to distinguish severe COVID-19 patients from non-severe cases with a level of accuracy considered fair to good based on AUROC values (95,100,107,109,112,113).…”

Neutralizing antibodies for the prevention and treatment of COVID-19

“…Coronavirus disease 2019 (COVID-19) is a newly emerged infectious disease first identified in December 2019. The major clinical features of COVID-19 include fever, shortness of breath, cough, headache, and fatigue, which can lead to severe pneumonia, lung injury, acute respiratory/multiorgan failure, and death [ 1 – 4 ]. A variety of risk factors, including older age, hypertension, obesity, diabetes mellitus, and cardiovascular comorbidities, are associated with COVID-19 [ 5 – 8 ].…”