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Medicine (Baltimore) ; 100(9): e24604, 2021 Mar 05.
Article in English | MEDLINE | ID: covidwho-1114903


ABSTRACT: Mortality of critically ill patients with coronavirus disease 2019 (COVID-19) was high. Aims to examine whether time from symptoms onset to intensive care unit (ICU) admission affects incidence of extra-pulmonary complications and prognosis in order to provide a new insight for reducing the mortality. A single-centered, retrospective, observational study investigated 45 critically ill patients with COVID-19 hospitalized in ICU of The Third People's Hospital of Yichang from January 17 to March 29, 2020. Patients were divided into 2 groups according to time from symptoms onset to ICU admission (>7 and ≤7 days) and into 2 groups according to prognosis (survivors and non-survivors). Epidemiological, clinical, laboratory, radiological characteristics and treatment data were studied. Compared with patients who admitted to the ICU since symptoms onset ≤7 days (55.6%), patients who admitted to the ICU since symptoms onset >7 days (44.4%) were more likely to have extra-pulmonary complications (19 [95.0%] vs 16 [64.0%], P = .034), including acute kidney injury, cardiac injury, acute heart failure, liver dysfunction, gastrointestinal hemorrhage, hyperamylasemia, and hypernatremia. The incidence rates of acute respiratory distress syndrome, pneumothorax, and hospital-acquired pneumonia had no difference between the 2 groups. Except activated partial thromboplastin and Na+ concentration, the laboratory findings were worse in group of time from symptoms onset to ICU admission >7 days. There was no difference in mortality between the 2 groups. Of the 45 cases in the ICU, 19 (42.2%) were non-survivors, and 16 (35.6%) were with hospital-acquired pneumonia. Among these non-survivors, hospital-acquired pneumonia was up to 12 (63.2%) besides higher incidence of extra-pulmonary complications. However, hospital-acquired pneumonia occurred in only 4 (15.4%) survivors. Critically ill patients with COVID-19 who admitted to ICU at once might get benefit from intensive care via lower rate of extra-pulmonary complications.

COVID-19 , Critical Care , Critical Illness , Symptom Assessment , Time-to-Treatment/statistics & numerical data , Acute Kidney Injury/diagnosis , Acute Kidney Injury/etiology , COVID-19/complications , COVID-19/diagnosis , COVID-19/mortality , COVID-19/physiopathology , China/epidemiology , Critical Care/methods , Critical Care/statistics & numerical data , Critical Illness/mortality , Critical Illness/therapy , Digestive System Diseases/diagnosis , Digestive System Diseases/etiology , Female , Healthcare-Associated Pneumonia/diagnosis , Healthcare-Associated Pneumonia/mortality , Heart Diseases/diagnosis , Humans , Hyperamylasemia/diagnosis , Hyperamylasemia/etiology , Hypernatremia/diagnosis , Hypernatremia/etiology , Male , Middle Aged , Outcome and Process Assessment, Health Care , Prognosis , SARS-CoV-2/isolation & purification , Survival Analysis , Symptom Assessment/methods , Symptom Assessment/statistics & numerical data
J Glob Health ; 10(2): 020504, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-895675


BACKGROUND: We are communicating the results of investigating statistics on SARS-CoV-2-related pneumonias in Russia: percentage, mortality, cases with other viral agents, cases accompanied by secondary bacterial pneumonias, age breakdown, clinical course and outcome. METHODS: We studied two sampling sets (Set 1 and Set 2). Set 1 consisted of results of testing 3382 assays of out-patients and hospital patients (5-88 years old) with community-acquired and hospital-acquired pneumonia of yet undetermined aetiology. Set 2 contained results of 1204 assays of hospital patients (12-94 years old) with pneumonia and COVID-19 already diagnosed by molecular biological techniques in test laboratories. The results were collected in twelve Russian cities/provinces in time range 2 March - 5 May 2020. Assays were analysed for 10 bacterial, 15 viral, 2 fungal and 2 parasitic aetiological agents. RESULTS: In Set 1, 4.35% of total pneumonia cases were related to SARS-CoV-2, with substantially larger proportion (18.75%) of deaths of pneumonia with COVID-19 diagnosed. However, studying Set 2, we revealed that 52.82% patients in it were also positive for different typical and atypical aetiological agents usually causing pneumonia. 433 COVID-19 patients (35.96%) were tested positive for various bacterial aetiological agents, with Streptococcus pneumoniae, Staphylococcus aureus and Haemophilus influenzae infections accounting for the majority of secondary pneumonia cases. CONCLUSIONS: SARS-CoV-2, a low-pathogenic virus itself, becomes exceptionally dangerous if secondary bacterial pneumonia attacks a COVID-19 patient as a complication. An essential part of the severest complications and mortality associated with COVID-19 in Russia in March-May 2020, may be attributed to secondary bacterial pneumonia and to a much less extent viral co-infections. The problem of hospital-acquired bacterial infection is exceptionally urgent in treating SARS-CoV-2 patients. The risk of secondary bacterial pneumonia and its further complications, should be given very serious attention in combating SARS-CoV-2.

Betacoronavirus , Coinfection/mortality , Coronavirus Infections/mortality , Healthcare-Associated Pneumonia/mortality , Pneumonia, Bacterial/mortality , Pneumonia, Viral/mortality , Virus Diseases/mortality , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Child , Child, Preschool , Coinfection/microbiology , Coronavirus Infections/microbiology , Female , Healthcare-Associated Pneumonia/microbiology , Humans , Male , Middle Aged , Pandemics , Pneumonia, Bacterial/microbiology , Pneumonia, Viral/microbiology , Russia/epidemiology , SARS-CoV-2 , Virus Diseases/microbiology , Young Adult