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Poor prognosis of patients with severe COVID-19 admitted to an infectious disease intensive care unit during the pandemic caused by the Delta variant in Japan.
Sekihara, Keigo; Shibasaki, Takatoshi; Okamoto, Tatsuya; Matsumoto, Chihiro; Ito, Kuniaki; Fujimoto, Kana; Kato, Fumito; Matsuda, Wataru; Kobayashi, Kentaro; Sasaki, Ryo; Uemura, Tatsuki; Kimura, Akio; Sugiyama, Haruhito; Kokudo, Norihiro.
  • Sekihara K; Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Shibasaki T; Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Okamoto T; Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Matsumoto C; Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Ito K; Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Fujimoto K; Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Kato F; Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Matsuda W; Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Kobayashi K; Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Sasaki R; Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Uemura T; Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Kimura A; Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Sugiyama H; Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Kokudo N; Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
Glob Health Med ; 4(2): 122-128, 2022 Apr 30.
Article in English | MEDLINE | ID: covidwho-1955545
ABSTRACT
During the surge of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) delta variant, our institution operated an intensive care unit (ICU) for patients with severe COVID-19. The study aim was to determine the survival rate and treatment outcomes of patients with severe COVID-19 treated in the ICU during the surge. A total of 23 consecutive patients with severe COVID-19 were admitted to the ICU between August 5 and October 6, 2021. Patients received multidrug therapy consisting of remdesivir, tocilizumab, heparin, and methylprednisolone. The patients were divided into two groups based on the ordinal scale (OS) a non-invasive oxygen therapy (OS-6) group, and an invasive oxygen therapy (OS-7) group. There were 13 (57%) and 10 (43%) patients in the OS-7 and OS-6 groups, respectively. All patients were unvaccinated. Sixteen patients (70%) were male. The median age was 53 years; the median body mass index (BMI) was 30.3 kg/m2; and the median P/F ratio on admission was 96. The 30-day survival rate was 69% and was significantly poorer in the OS-7 group (54%) than in the OS-6 group (89%; p = 0.05). The prevalence of obesity (p = 0.05) and the Sequential Organ Failure Assessment (SOFA) score on admission (p < 0.01) were significantly higher in the OS-7 group. Seven patients in the OS-7 group (54%) developed bacteremia. A low P/F ratio on admission was a significant unfavorable prognostic factor (hazard ratio 10.9; p = 0.03). The survival rate was poor, especially in patients requiring invasive oxygen therapy. More measures are needed to improve the treatment outcomes of patients with severe COVID 19.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Variants Language: English Journal: Glob Health Med Year: 2022 Document Type: Article Affiliation country: Ghm.2021.01121

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Variants Language: English Journal: Glob Health Med Year: 2022 Document Type: Article Affiliation country: Ghm.2021.01121