RESUMO
Background: The coronavirus disease (COVID-19) pandemic imposed a major public health impact. Septic shock is one of the frequent complications encountered among critically ill COVID-19 patients, leading to poor healthcare outcomes. This study aimed at assessing the magnitude of septic shock and its associated factors. Methods and materials: An institution-based cross-sectional study was conducted retrospectively on 242 randomly selected COVID-19 patients admitted to three Addis Ababa COVID-19 care centers from September 2020 to October 2021. Septic shock was defined as a Sequential Organ Failure Assessment (SOFA) score ≥2 points and persisting hypotension requiring vasopressors to maintain a mean arterial pressure of ≥65 mmHg despite adequate volume resuscitation. Variables in the bivariate analysis were fitted to multiple regression analysis to eliminate confounders and determine independent risk factors for septic shock. In the multivariable analysis, statistical significance was declared at P < .05. Results: The prevalence of septic shock was found to be 39.3% (95% confidence interval [CI]: 33.1, 45.7). Advanced age (≥60 years) [AOR = 7.9; 95% CI: 2.3, 26.8], intensive care unit stay above 7 days [AOR = 6.2; 95%CI: 2.1, 18.7], invasive ventilation [AOR = 10; 95% CI: 3, 37], and chronic obstructive pulmonary disease (COPD) [AOR = 18; 95% CI: 7, 45] were significantly associated with increased septic shock among COVID-19 patients. Meanwhile, diabetes [AOR = 0.24; 95% CI: 0.08, 0.71] and cardiovascular diseases [AOR = 0.17; 95% CI: 0.07, 0.44] were associated with a decrease risk of septic shock. Conclusion: The prevalence of septic shock in critically ill COVID-19 patients was high and a major concern in this study, and it is independently associated with advanced age, prolonged stay in the intensive care unit, and COPD. Based on these findings, healthcare professionals should closely monitor and manage patients with COVID-19 who have a history of COPD, are older, or prolonged intensive care unit (ICU) stays to prevent septic shock and improve patient outcomes.
RESUMO
Introduction: New onset of diabetes mellitus was noted as the commonest comorbidity in the COVID-19 pandemic, which contributed to a worse prognosis. Existing evidence showed that new-onset diabetes is associated with increased mortality compared to nondiabetic and known diabetic patients in the COVID-19 era. SARS-CoV-2 virus can worsen existing diabetes; at the same time, it can trigger new-onset diabetes that eventually worsens patient outcomes. Thus, this study is aimed at determining the prevalence and factors associated with new onset of diabetes mellitus among COVID-19 patients. Methods: Institution-based retrospective cross-sectional study design was conducted by reviewing 244 patient's records in the Addis Ababa COVID-19 care center. Descriptive statistics and binary logistic regression were used. During bivariate analysis, variables with p ≤ 0.25 were transferred into multivariate analysis. Adjusted odds ratios to determine the strength and presence of the association with a 95% confidence interval and p value ≤ 0.05 were considered, respectively. Results: The mean age of the study participants was 53.2 years with (SD = 13.35). The study findings showed that 31.1% (CI: 25.4-37.4) of COVID-19 patients had new onset of diabetes mellitus; of those, 11.8% had type 1 and 88.2% had type 2 diabetes. Being male (aOR = 2.9; 95% CI: 1.2, 7.1), family history of hypertension (aOR = 3.7; 95% CI: 1.3, 10.5), obesity (aOR = 3.1; 95% CI: 1.01, 8.9), having pulmonary embolism (aOR = 0.2; 95% CI: 0.06, 0.04), and hyperkalemia (aOR = 9.3; 95% CI: 1.8, 47.3) showed statistically significant association with new onset of diabetes mellitus. Conclusion: A significant proportion of COVID-19 patients had been diagnosed with new onset of diabetes mellitus, and new-onset type 2 diabetes mellitus is the most common diabetes mellitus type. Being male, obesity, having a pulmonary embolism, family history of hypertension, and hyperkalemia were independently associated with new onset of diabetes mellitus among COVID-19 patients. Therefore, focused interventions need to be strengthened towards the identified factors.