ABSTRACT
Background: COVID-19 can lead to severe acute respiratory syndrome so that some patients need to be admitted to the Intensive Care Unit (ICU). The aim of the current study is to investigate the frequency of demographic, laboratory and imaging findings and type of treatment and their relationship with disease outcomes in patients with COVID-19. Material and Methods: This prospective cross-sectional study was conducted on all patients with COVID-19 who were admitted in the ICU of Razi Hospital in Ahvaz, Iran from January 20 to February 20, 2021. Patient information including demographic features, laboratory and imaging findings and clinical outcomes was recorded. Results: One hundred and thirty-three patients were recruited in the present study, out of which 74 patients (55.6%) were males and 59 patients (44.4%) were females. The overall mortality rate of patients was 35.3% (47 patients) and was higher in patients over 65 years of age. There was a significant difference in terms of thrombocytopenia (P value: 0.001), lymphopenia (P value: 0.004), progression of lung involvement in imaging, shock, disseminated intravascular coagulation (DIC), sepsis and receiving invasive respiratory support in living and deceased patients (P value < 0.001). Furthermore, the difference in life status and the length of in-ICU stay in patients with hyperkalemia and renal failure was statistically significant (P value = 0.033, P value < 0.001 respectively). Conclusion: Mortality rate of patients with COVID- 19 admitted to ICU is generally high. According to the findings of this study, thrombocytopenia, lymphopenia, hyperkalemia and AKI are laboratory disorders associated with increased mortality. Moreover, the progression of pulmonary involvement in imaging, shock, DIC, sepsis, and need to invasive respiratory support is associated with low survival of patients.
ABSTRACT
INTRODUCTION: Cisplatin is an efficient chemotherapeutic drug used for the treatment of different cancers. Clinical trials represents cisplatin-induced nephrotoxicity in a dose dependent manner. OBJECTIVES: This study aimed to compare the effects of 1-day treatment regimen with cisplatin on renal function, potassium, calcium, magnesium and uric acid in patients with gastric and lung cancer compared with 2-day divided cisplatin treatment regimen to suggest appropriate management for decrease nephrotoxic effects and >electrolyte abnormalities. PATIENTS AND METHODS: The study was conducted as a randomized clinical trial. The sample consisted of 60 patients with gastric and lung cancer treated with cisplatin in Ahvaz Shafa hospital. Patients were randomly divided into 2 equal groups. Both groups were treated with cisplatin over a period of 6 to 18 weeks. The first group received 50 mg/m(2)/day of cisplatin during one day and the second group received 25 mg/m(2)/day in 2 days. Electrolytes in each period and renal function at baseline and 6 months after starting treatment was assessed. RESULTS: Difference of mean of renal function and nephrotoxicity incidence in the 2 groups was statistically significant. The odds of hypokalemia in 1-day group was higher than 2-day group (odds ratio [OR] = 6.5), which was statistically significant. However there was no significant relationship between the types of treatment and the risk of hypocalcemia, hypomagnesemia and hyperuricemia. CONCLUSION: The result of this study showed that, the divided administration of cisplatin reduces the nephrotoxic and hypokalemia effects of this drug, however it had not significant influence on hypomagnesemia, hypocalcaemia, and hyperuricemia.
