Predictive factors of six-week mortality in critically ill patients with SARS-CoV-2: A multicenter prospective study.
Med Intensiva (Engl Ed)
; 46(4): 179-191, 2022 04.
Article
in English
| MEDLINE | ID: covidwho-1829191
ABSTRACT
OBJECTIVE:
The objective of the study is to identify the risk factors associated with mortality at six weeks, especially by analyzing the role of antivirals and munomodulators.DESIGN:
Prospective descriptive multicenter cohort study.SETTING:
26 Intensive care units (ICU) from Andalusian region in Spain. PATIENTS ORPARTICIPANTS:
Consecutive critically ill patients with confirmed SARS-CoV-2 infection were included from March 8 to May 30.INTERVENTIONS:
None. VARIABLES Variables analyzed were demographic, severity scores and clinical condition. Support therapy, drug and mortality were analyzed. An univariate followed by multivariate Cox regression with propensity score analysis was applied.RESULTS:
495 patients were enrolled, but 73 of them were excluded for incomplete data. Thus, 422 patients were included in the final analysis. Median age was 63 years and 305 (72.3%) were men. ICU mortality 144/422 34%; 14 days mortality 81/422 (19.2%); 28 days mortality 121/422 (28.7%); 6-week mortality 152/422 36.5%. By multivariable Cox proportional analysis, factors independently associated with 42-day mortality were age, APACHE II score, SOFA score at ICU admission >6, Lactate dehydrogenase at ICU admission >470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission <6.5%, and thrombocytopenia whereas the use of lopinavir/ritonavir was a protective factor.CONCLUSION:
Age, APACHE II, SOFA>value of 6 points, along with vasopressor requirements or renal replacement therapy have been identified as predictor factors of mortality at six weeks. Administration of corticosteroids showed no benefits in mortality, as did treatment with tocilizumab. Lopinavir/ritonavir administration is identified as a protective factor.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
SARS-CoV-2
/
COVID-19
Type of study:
Cohort study
/
Etiology study
/
Observational study
/
Prognostic study
Limits:
Female
/
Humans
/
Infant
/
Male
/
Middle aged
Language:
English
Journal:
Med Intensiva (Engl Ed)
Year:
2022
Document Type:
Article
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