ABSTRACT
PURPOSE: Evaluate the associations of obesity and diabetes with the risk of mortality in critically ill patients infected with SARS-CoV-2. MATERIALS AND METHODS: This cohort study included 115 adult patients admitted to the ICU with SARS-CoV-2 pneumonia. Anthropometric variables and biochemical (C-reactive protein, ferritin, leukocyte, neutrophils, and fibrinogen) were measured. Multivariate logistic regression analyses were used to investigate the associations. RESULTS: Mean age was 50.6±11.2 years, 68.7% were male. Median BMI was 30.9kg/m2. All patients had invasive mechanical ventilation. Patients with diabetes had increased risk of mortality with OR of 2.86 (CI 95% 1.1-7.4, p=0.026); among those patients who, in addition to diabetes had obesity, the risk was de 3.17 (CI 95% 1.9-10.2, p=0.038). Patients with obesity had 1.25 times greater risk of developing a severe SARS-CoV-2 infection (95% CI 1.09-1.46, p=0.025). Negative correlation was observed between BMI and the PaO2/FiO2 ratio (r=-0.023, p<0.05). Obese patients required more days of mechanical ventilation and longer hospital stay compared to non-obese patients. CONCLUSIONS: Diabetes and obesity are risk factors for increasing severity of SARS-CoV-2 infection, and they are both associated with an increase in mortality.
Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Obesity , Adult , Body Mass Index , COVID-19/complications , COVID-19/mortality , Cohort Studies , Critical Illness , Diabetes Mellitus, Type 2/complications , Female , Humans , Logistic Models , Male , Middle Aged , Multivariate Analysis , Obesity/complicationsSubject(s)
COVID-19 , Pandemics , Humans , Respiration, Artificial , SARS-CoV-2 , Ventilators, MechanicalABSTRACT
INTRODUCTION: Simultaneous mechanical ventilation of several patients with a single ventilator might reduce the deficit of these devices for the care of patients with acute respiratory failure due to Covid-19. OBJECTIVE: To communicate the results of a mechanical ventilation exercise with a ventilator in a lung simulator, and simultaneously in two and four. RESULTS: No statistically significant differences were observed between programmed, recorded and measured positive end-expiratory pressure, mean airway pressure and peak pressure, except when simultaneously ventilating four lung simulators. CONCLUSIONS: Simultaneous mechanical ventilation should be implemented by medical personnel with experience in the procedure, be restricted to two patients and carried out in the intensive care unit.
INTRODUCCIÓN: La ventilación mecánica simultánea a varios pacientes con un solo ventilador podría disminuir el déficit de esos dispositivos para atender a los enfermos con insuficiencia respiratoria aguda por Covid-19. OBJETIVO: Comunicar los resultados de un ejercicio de ventilación mecánica con un ventilador en un simulador de pulmón, y simultáneamente en dos y cuatro. RESULTADOS: No se observaron diferencias estadísticamente significativas entre la presión positiva al final de la espiración, presión media de la vía aérea y presión pico programadas, registradas y medidas, excepto al ventilar simultáneamente cuatro simuladores de pulmón. CONCLUSIONES: La ventilación mecánica simultánea debe ser instaurada por personal médico con experiencia en el procedimiento, restringirse a dos pacientes y ser realizada en la unidad de cuidados intensivos.