ABSTRACT
During intensive care unit (ICU) management of COVID-19, blood tests are often conducted for close monitoring of patients, a poor prognostic factor for survival, especially in hypoxemic patients. This study aimed to determine the degree of anemia and its effect on prognosis in ICU COVID-19 patients. This retrospective study included COVID-19 patients admitted to the ICU between 1 October 2020 and 1 May 2021. All the patients included were aged > 18 years and stayed in the ICU for >=14 days. Patients aged <18 years, those with major bleeding, and those recovering from surgery were excluded. The total blood samples (mL) taken in the ICU were calculated. From among the 395 patients screened for inclusion, 112 patients were included in the study. Mean age of the patients was 71.3 +/- 13.2 years (Male/Female: 1.8). Mean hemoglobin (Hb) at admission was 13.2 +/- 1.8 g dL-1. At the end of the ICU stay mean Hb was 9.74 +/- 1.98 g dL-1. During ICU stay, the mean reduction in Hb was 3.47 +/- 2.11 g dL-1. Age (p= 0.049), drawn blood volume per day (p= 0.001), and higher hemoglobin at admission (p= 0.001) were determined by multivariate analysis as independent risk factors for hemoglobin reduction. Hemoglobin reduction (OR: 1.34), and intubation status (OR: 57.50) were independent risk factors for mortality. Considering that most COVID-19 patients are admitted to the ICU due to acute respiratory failure (ARF), it is vital to maintain the Hb level as high as possible, so as to maintain oxygenation.Copyright © 2022, UHOD - Uluslararasi Hematoloji Onkoloji Dergisi. All rights reserved.
ABSTRACT
During intensive care unit (ICU) management of COVID-19, blood tests are often conducted for close monitoring of patients, a poor prognostic factor for survival, especially in hypoxemic patients. This study aimed to determine the degree of anemia and its effect on prognosis in ICU COVID-19 patients. This retrospective study included COVID-19 patients admitted to the ICU between 1 October 2020 and 1 May 2021. All the patients included were aged > 18 years and stayed in the ICU for >= 14 days. Patients aged <18 years, those with major bleeding, and those recovering from surgery were excluded. The total blood samples (mL) taken in the ICU were calculated. From among the 395 patients screened for inclusion, 112 patients were included in the study. Mean age of the patients was 71.3 +/- 13.2 years (Male/Female: 1.8). Mean hemoglobin (Hb) at admission was 13.2 +/- 1.8 g dL-1. At the end of the ICU stay mean Hb was 9.74 +/- 1.98 g dL-1. During ICU stay, the mean reduction in Hb was 3.47 +/- 2.11 g dL-1. Age (p= 0.049), drawn blood volume per day (p= 0.001), and higher hemoglobin at admission (p= 0.001) were determined by multivariate analysis as independent risk factors for hemoglobin reduction. Hemoglobin reduction (OR: 1.34), and intubation status (OR: 57.50) were independent risk factors for mortality. Considering that most COVID-19 patients are admitted to the ICU due to acute respiratory failure (ARF), it is vital to maintain the Hb level as high as possible, so as to maintain oxygenation.
ABSTRACT
Introduction: Cardiac etiology may play a role in deaths due to the Coronavirus disease 2019 (COVID-19). Therefore, the relationship between troponin I and mortality in critical COVID-19 patients is of interest. Troponin I, one of the heart-specific proteins, is used as a biomarker to detect myocardial necrosis. In the present study, our aim is to demonstrate the relationship of the Troponin I trend with mortality in critical COVID-19 patients. Materials and methods: A retrospective analysis was carried out for critical COVID-19 patients who were admitted to the intensive care unit at Ankara City Hospital, a tertiary center, during the early period of the pandemic between March 18, 2020 and April 28, 2020. The patients, whose Troponin I were measured regularly and for the longest period, were selected in order to draw the trends. These patients were distributed into two groups as survivor and death groups according to mortality in the intensive care unit. Results: It was found that 18 of the 66 critical COVID-19 patients, the troponin I concentration was measured regularly every day for a period of minimum 13 days. The mean age ± SEM (Standard error of mean) was 68.25±4.28 years in the survivor group and 70.83±2.58 years in the death group (P>0.05). The mean APACHE II ± SEM was 16.08±2.95 in the survivor group and 36.17±5.67 in the death group (P<0.05). The mean troponin I concentration ± SEM on day 13 was 63.26±39.90 ng/L in the death group, while the mean troponin I ± SEM was 12.01±5.03 ng/L (P<0.05) in the survivor group. Conclusion: The elevation in the troponin I trend in patients with COVID-19 was associated with mortality. In critically ill patients who survived, the mean troponin I approximately 5 times lower on day 13 compared to the patients who did not survive. Despite all vital supportive treatments, some of the patients with COVID-19 rapidly progressed to death. Monitoring the changes in troponin I trend can indicate the severity and prognosis of the disease. © 2021 A. CARBONE Editore. All rights reserved.