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Clinical characteristics and mortality risk among critically ill patients with COVID-19 owing to the B.1.617.2 (Delta) variant in Vietnam: A retrospective observational study.
Do, Thanh Van; Manabe, Toshie; Vu, Giap Van; Nong, Vuong Minh; Fujikura, Yuji; Phan, Dung; Pham, Thach The; Do, Cuong Duy; Doan, Tra Thu; Nguyen, Nguyen Trung; Nguyen, Thai Quoc; Dong, Thanh Van; Luong, Chinh Quoc; Manabe, Hiroki; Kambayashi, Dan; Hoang, Anh Viet; Vu, Nhan Van; Trinh, Giang Kim; Do, Son Ngoc; Kamiya, Takeshi; Ohara, Hirotaka; Nguyen, Chi Van; Dang, Tuan Quoc; Kudo, Koichiro; Dao, Co Xuan.
  • Do TV; Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam.
  • Manabe T; Nagoya City University Graduate School of Medicine, Nagoya city, Aichi, Japan.
  • Vu GV; Nagoya City University West Medical Center, Nagoya city, Aichi, Japan.
  • Nong VM; Hanoi Medical University, Hanoi, Vietnam.
  • Fujikura Y; Respiratory Center, Bach Mai Hospital, Hanoi, Vietnam.
  • Phan D; Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam.
  • Pham TT; Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan.
  • Do CD; Department of Medical Risk Management and Infection Control, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan.
  • Doan TT; Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia.
  • Nguyen NT; Intensive Care Center, Bach Mai Hospital, Hanoi, Vietnam.
  • Nguyen TQ; Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam.
  • Dong TV; Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam.
  • Luong CQ; Poison Control Center, Bach Mai Hospital, Hanoi, Vietnam.
  • Manabe H; Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam.
  • Kambayashi D; Outpatient Department, Bach Mai Hospital, Hanoi, Vietnam.
  • Hoang AV; Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Vietnam.
  • Vu NV; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Vietnam.
  • Trinh GK; Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam.
  • Do SN; Shitennoji University, Habikino city, Osaka, Japan.
  • Kamiya T; Nagoya City University Graduate School of Medicine, Nagoya city, Aichi, Japan.
  • Ohara H; Showa Pharmaceutical University, Machidashi, Tokyo, Japan.
  • Nguyen CV; Training and Direction of Healthcare Activities Center, Bach Mai Hospital, Hanoi, Vietnam.
  • Dang TQ; Training and Direction of Healthcare Activities Center, Bach Mai Hospital, Hanoi, Vietnam.
  • Kudo K; Training and Direction of Healthcare Activities Center, Bach Mai Hospital, Hanoi, Vietnam.
  • Dao CX; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Vietnam.
PLoS One ; 18(1): e0279713, 2023.
Article in English | MEDLINE | ID: covidwho-2214788
ABSTRACT

BACKGROUND:

SARS-CoV-2 Delta variant caused a large number of COVID-19 cases in many countries, including Vietnam. Understanding mortality risk factors is crucial for the clinical management of severe COVID-19.

METHODS:

We conducted a retrospective study at an intensive care center in Ho Chi Minh City that urgently built by Bach Mai Hospital during the COVID-19 outbreak in Vietnam, when the Delta variant predominated. Participants were laboratory-confirmed patients with SARS-CoV-2 infection, admitted in August 2021. Data on patients' demographic and clinical characteristics, radiographic and laboratory findings, treatment, and clinical time course were compared between survivors and non-survivors. Risk factors to mortality were assessed using logistic regression.

RESULTS:

Among 504 eligible COVID-19 patients, case fatality was 52.2%. Unvaccinated patients accounted for 61.2% of non-survivors and 43.6% of survivors (p < 0.001). The time from onset to hospital admission was 8 days in non-survivors and 7 days in survivors (p = 0.004). Among non-survivors, 90.2% developed acute respiratory distress syndrome (ARDS). Oxygen therapy was administered for all patients, but antiviral agent was given to 51.7% of non-survivors. 54.2% of non-survivors tested positive for the bacterial infection using blood culture. The risk factors for mortality were diabetes mellitus, respiration rate, oxygen saturation, vaccination status, time from onset to admission, and older age.

CONCLUSIONS:

Critical patients with COVID-19 owing to the Delta variant in Vietnam had delayed hospital admission, leading to ARDS and death. Early availability of vaccines and preventing bacterial infections are crucial for reducing mortality of COVID-19, especially in low- and middle-income countries.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / COVID-19 Type of study: Observational study / Prognostic study Topics: Vaccines / Variants Limits: Humans Country/Region as subject: Asia Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2023 Document Type: Article Affiliation country: Journal.pone.0279713

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / COVID-19 Type of study: Observational study / Prognostic study Topics: Vaccines / Variants Limits: Humans Country/Region as subject: Asia Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2023 Document Type: Article Affiliation country: Journal.pone.0279713