Role and Experience of a Subintensive Care Unit in Caring for Patients with COVID-19 in Italy: The CO-RESP Study
Journal of Clinical Outcomes Management
; 29(1):16-24, 2022.
Article
in English
| EMBASE | ID: covidwho-1897193
ABSTRACT
Objective:
This retrospective and prospective cohort study was designed to describe the characteristics, treatments, and outcomes of patients with SARS-CoV-2 infection (COVID-19) admitted to subintensive care units (SICU) and to identify the variables associated with outcomes. SICUs have been extremely stressed during the pandemic, but most data regarding critically ill COVID-19 patients come from intensive care units (ICUs). Studies about COVID-19 patients in SICUs are lacking. Setting andparticipants:
The study included 88 COVID-19 patients admitted to our SICU in Cuneo, Italy, between March and May 2020. Measurements Clinical and ventilatory data were collected, and patients were divided by outcome. Multivariable logistic regression analysis examined the variables associated with negative outcomes (transfer to the ICU, palliation, or death in a SICU).Results:
A total of 60 patients (68%) had a positive outcome, and 28 patients (32%) had a negative outcome;69 patients (78%) underwent continuous positive airway pressure (CPAP). Pronation (n=37 [42%]) had been more frequently adopted in patients who had a positive outcome vs a negative outcome (n=30 [50%] vs n=7 [25%];P=.048), and the median (interquartile range) Pao2/Fio2 ratio after 6 hours of prone positioning was lower in patients who had a negative outcome vs a positive outcome (144 [140-168] vs 249 [195-268], P=.006). Independent predictors of a negative outcome were diabetes (odds ratio [OR], 8.22;95% CI, 1.50-44.70;P=.015), higher D-dimer (OR, 1.28;95% CI, 1.04-1.57;P=.019), higher lactate dehydrogenase level (OR, 1.003;95% CI, 1.000-1.006;P=.039), and lower lymphocytes count (OR, 0.996;95% CI, 0.993-0.999;P=.004).Conclusion:
SICUs have a fundamental role in the treatment of critically ill patients with COVID-19, who require long-term CPAP and pronation cycles. Diabetes, lymphopenia, and high D-dimer and LDH levels are associated with negative outcomes.
adult; article; artificial ventilation; care behavior; cohort analysis; continuous positive airway pressure; controlled study; coronavirus disease 2019; critically ill patient; diabetes mellitus; emergency medicine; female; gene expression; Horowitz index; human; intensive care unit; Italy; lymphocyte count; lymphocytopenia; major clinical study; male; noninvasive ventilation; outcome assessment; palliative therapy; pronation; prone position; prospective study; retrospective study; D dimer; endogenous compound; lactate dehydrogenase
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Journal of Clinical Outcomes Management
Year:
2022
Document Type:
Article
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