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Eur Rev Med Pharmacol Sci ; 24(24): 13065-13071, 2020 12.
Artículo en Inglés | MEDLINE | ID: covidwho-1000853

RESUMEN

OBJECTIVE: Whether patients with COVID-19 require invasive mechanical ventilation (MV) is not yet clear. This article summarizes the clinical treatment process and clinical data of patients with COVID-19 and analyzes the predictive factors for mechanical ventilation for these patients. MATERIALS AND METHODS: A retrospective study was carried out from January 5, 2020, to March 23, 2020, including 98 patients with COVID-19 treated at three designated hospitals in Huangshi City, Hubei Province. Data collection included demographics, previous underlying diseases, clinical manifestations, laboratory examinations, imaging examination results, diagnosis, and prognosis. This study presents a summary of the patients' overall clinical characteristics and clarifies the predictive factors for MV in patients with COVID-19. RESULTS: There were 56 males and 42 females included in this study. The mortality rate was 26.53% (26/98). Fever, cough, and chest tightness were the most common symptoms (64.3%, 37.8%, and 12.2%, respectively). Thirty cases required MV, 30.61% of the total cases, and the mortality rate was 73.33%. The univariate comparison showed that dyspnea, acute physiologic assessment, chronic health evaluation (APACHE II) score, and the ratio between arterial blood oxygen partial pressure (PaO2) and oxygen concentration (FiO2) (P/F) were statistically different between the MV group and the non-MV group (p < 0.05). CONCLUSIONS: Results showed the following: dyspnea; increased white blood cell count; decreased platelets; lowered albumin levels; increased urea nitrogen; increased levels of myocardial enzymes Creatine Kinase (CK), Creatine Kinase, MB Form (CKMB) and lactate dehydrogenase (LDH); increased lactate, and lowered blood calcium tests. These findings may indicate that the patients have an increased probability of needing MV support. A cutoff value for the initial APACHE II score of >11.5 and the initial PaO2/FiO2 ratio of <122.17 mmHg should be considered for MV support for patients with COVID-19.


Asunto(s)
COVID-19/terapia , Oxígeno/sangre , Presión Parcial , Respiración Artificial/estadística & datos numéricos , APACHE , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Nitrógeno de la Urea Sanguínea , COVID-19/sangre , COVID-19/mortalidad , COVID-19/fisiopatología , Creatina Quinasa/sangre , Forma MB de la Creatina-Quinasa/sangre , Disnea/fisiopatología , Femenino , Humanos , Hipoalbuminemia/sangre , Hipocalcemia/sangre , L-Lactato Deshidrogenasa/sangre , Ácido Láctico/sangre , Leucocitosis/sangre , Masculino , Persona de Mediana Edad , Curva ROC , Estudios Retrospectivos , Medición de Riesgo , SARS-CoV-2 , Trombocitopenia/sangre
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