Research Article
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Year 2023, , 470 - 481, 29.12.2023
https://doi.org/10.5798/dicletip.1411504

Abstract

References

  • 1.WHO Coronavirus (COVID-19) Dashboard | WHOCoronavirus (COVID-19) Dashboard With VaccinationData. Accessed 2023 October 5. Available from:https://covid19.who.int/
  • 2.Word Health Organization. EG.5 Initial Risk Evaluation,9 August 2023. Accessed 2023 October 5. Available:https://www.who.int/docs/default-source/coronaviruse/09082023eg.5_ire_final.pdf?sfvrsn=2aa2daee_1
  • 3.Adjei S, Hong K, Molinari NM, et al. Mortality RiskAmong Patients Hospitalized Primarily for COVID-19During the Omicron and Delta Variant Pandemic Periods-United States, April 2020-June 2022. MMWR MorbMortal Wkly Rep. 2022; 71(37):1182-9.
  • 4. Zanella A, Florio G, Antonelli M, et al. Time course of risk factors associated with mortality of 1260 critically illpatients with COVID-19 admitted to 24 Italian intensivecare units. Intensive Care Med. 2021; 47(9):995-1008.
  • 5.Silverio A, Di Maio M, Citro R, et al. Cardiovascular riskfactors and mortality in hospitalized patients with COVID-19: systematic review and meta-analysis of 45 studiesand 18,300 patients. BMC Cardiovasc Disord.2021;21(1):23.
  • 6.Zhou F, Yu T, Du R, et al. Clinical course and risk factorsfor mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet.2020;395(10229):1054-62.
  • 7.Dessie ZG, Zewotir T. Mortality-related risk factors ofCOVID-19: a systematic review and meta-analysis of 42studies and 423,117 patients. BMC Infect Dis.2021;21(1):855.
  • 8.Armstrong RA, Kane AD, Kursumovic E, Oglesby FC,Cook TM. Mortality in patients admitted to intensive carewith COVID-19: an updated systematic review and meta-analysis of observational studies. Anaesthesia. 2021;76(4):537-48.
  • 9. Armstrong RA, Kane AD, Cook TM. Decreasing mortalityrates in ICU during the COVID-19 pandemic. Anaesthesia. 2021:76 (3):10.
  • 10.Petrilli CM, Jones SA, Yang J, et al. Factors associatedwith hospital admission and critical illness among 5279people with coronavirus disease 2019 in New York City:prospective cohort study. BMJ. 2020; 369:m1966.
  • 11. Zhao Z, Chen A, Hou W, et al. Prediction model and risk scores of ICU admission and mortality in COVID-19. PLoSOne. 2020; 15(7): e0236618
  • 12.Li X, Marmar T, Xu Q, et al. Predictive indicators ofsevere COVID-19 independent of comorbidities andadvanced age: a nested case-control study. EpidemiolInfect. 2020; 148: e255.
  • 13.Crespi B, Alcock J. Conflicts over calcium and thetreatment of covid-19. Evol Med Public Heal. 2020;2019:149–56.
  • 14.Martha JW, Wibowo A, Pranata R. Hypocalcemia isassociated with severe COVID-19: A systematic reviewand meta-analysis. Diabetes Metab Syndr. 2021;15(1):337–42.
  • 15.Di Filippo L, Formenti AM, Rovere-Querini P, et al.Hypocalcemia is highly prevalent and predictshospitalization in patients with COVID-19. Endocrine.2020; 68(3): 475-8.
  • 16. Cappellini F, Brivio R, Casati M, et al. Low levels of totaland ionized calcium in blood of COVID-19 patients. ClinChem Lab Med. 2020; 58(9): e171–3.
  • 17.Fu Y, Zhu R, Bai T, et al. Clinical Features of COVID-19-Infected Patients With Elevated Liver Biochemistries: AMulticenter, Retrospective Study. Hepatology. 2021;73(4):1509-20.
  • 18.Ni W, Yang X, Yang D, et al. Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19. Crit Care.2020; 24(1): 422.
  • 19.Zhao Y, Zhao Z, Wang Y, et al. Single-Cell RNAExpression Profiling of ACE2, the Receptor of SARS-CoV-2.Am J Respir Crit Care Med. 2021; 203(6):782.
  • 20.Zhang H, Kang Z, Gong H, et al. The digestive system isa potential route of 2019-nCov infection: a bioinformaticsanalysis based on single-cell transcriptomes. Gut 2020;69:1010-18.
  • 21.Huang FY, Peng Y, Huang BT, et al. The correlationbetween serum total bilirubin and outcomes in patientswith different subtypes of coronary artery disease. ClinChim Acta. 2017; 465: 101–5.
  • 22.Boon AC, Bulmer AC, Coombes JS, Fassett RG.Circulating bilirubin and defense against kidney diseaseand cardiovascular mortality: Mechanisms contributingto protection in clinical investigations. Am J Physiol RenalPhysiol. 2014 ; 307(2): 123-36.
  • 23.Wagener FADTG, Pickkers P, Peterson SJ,Immenschuh S, Abraham NG. Targeting the Heme-HemeOxygenase System to Prevent Severe ComplicationsFollowing COVID-19 Infections. Antioxidants. 2020; 9(6):540.
  • 24.Patel JJ, Taneja A, Niccum D, et al. The association ofserum bilirubin levels on the outcomes of severe sepsis. JIntensive Care Med. 2015; 30(1): 23–9.
  • 25.Wu Y, Ren J, Wang G, et al. Direct bilirubin as aprognostic biomarker in enteric fistula patientscomplicated with sepsis: A case-control study. Int J ClinExp Med. 2014; 7(12): 5134–45.
  • 26.Wiśniewska H, Skonieczna-Żydecka K, Parczewski M,et al. Hepatotropic Properties of SARS-CoV-2-PreliminaryResults of Cross-Sectional Observational Study from theFirst Wave COVID-19 Pandemic. J Clin Med. 2021; 10(4):672.
  • 27.Lei F, Liu YM, Zhou F, et al. Longitudinal AssociationBetween Markers of Liver Injury and Mortality in COVID-19 in China. Hepatology. 2020; 72(2): 389–98.
  • 28.Wu J, Shi L, Zhang P, Wang Y, Yang H. Is creatinine anindependent risk factor for predicting adverse outcomesin COVID-19 patients? Transpl Infect Dis. 2021 ; 23(2):e13539
  • 29.Kazemi E, Soldoozi Nejat R, Ashkan F, Sheibani H. Thelaboratory findings and different COVID-19 severities: asystematic review and meta-analysis. Ann Clin MicrobiolAntimicrob. 2021; 20(1): 17.
  • 30.Danwang C, Endomba FT, Nkeck JR, et al. A meta-analysis of potential biomarkers associated with severityof coronavirus disease 2019 (COVID-19). Biomark Res.2020; 8(1): 37.

Independent Predictors of Mortality in ICU Patients with COVID-19

Year 2023, , 470 - 481, 29.12.2023
https://doi.org/10.5798/dicletip.1411504

Abstract

Objective: Early identification of Coronavirus disease 2019 (COVID-19) patients at high mortality risk can improve patient care and prevent deaths. To identify prognostic predictors that increase COVID-19 patient mortality risk in the Intensive Care Unit (ICU).
Methods: Retrospective analysis of clinical characteristics and serological biomarkers of ICU-COVID-19 patients was performed in a tertiary hospital from 24 March 2020 to 20 December 2020. Analysis was conducted on two groups of study participants: survivors and deceased. Multivariate logistic regression was used to determine mortality risk. In order to determine prognostic predictors, the ANOVA test was used to compare the data of serological biomarkers on the day of patients' admission to the ICU and on the 5th day of follow-up.
Results: A total of 335 patients (54.65%) were in the deceased group, and 278 (45.35%) were in the survivors group. A statistically significant difference was found between the deceased and survivor groups regarding mean age (p<0.001). According to multivariate analyses of patients' data, age, oxygen saturation, direct bilirubin, and ionized calcium were independent predictors of mortality (p <0.05). According to this analysis, age (OR=1.035, p=0.002, 95%CI 1.013-1.058), peripheral capillary oxygen saturation (SpO2) (OR=0.912, p<0.001, 95%CI 0,873-0.953), direct bilirubin (OR=6.821, p=0.024, 95%CI 0.282-36.285), ionized calcium (OR=30.524, p=0.035, 95%CI 1.262-738.34) was found that it increased the risk of mortality. In the multivariate logistic regression analysis, it was found that gender, age, and comorbidities had the highest odds ratios in terms of mortality.
Conclusion: The study revealed that advanced age, low SpO2, high direct bilirubin, and elevated ionized calcium levels were independent predictors of mortality for COVID-19 patients in the ICU.

References

  • 1.WHO Coronavirus (COVID-19) Dashboard | WHOCoronavirus (COVID-19) Dashboard With VaccinationData. Accessed 2023 October 5. Available from:https://covid19.who.int/
  • 2.Word Health Organization. EG.5 Initial Risk Evaluation,9 August 2023. Accessed 2023 October 5. Available:https://www.who.int/docs/default-source/coronaviruse/09082023eg.5_ire_final.pdf?sfvrsn=2aa2daee_1
  • 3.Adjei S, Hong K, Molinari NM, et al. Mortality RiskAmong Patients Hospitalized Primarily for COVID-19During the Omicron and Delta Variant Pandemic Periods-United States, April 2020-June 2022. MMWR MorbMortal Wkly Rep. 2022; 71(37):1182-9.
  • 4. Zanella A, Florio G, Antonelli M, et al. Time course of risk factors associated with mortality of 1260 critically illpatients with COVID-19 admitted to 24 Italian intensivecare units. Intensive Care Med. 2021; 47(9):995-1008.
  • 5.Silverio A, Di Maio M, Citro R, et al. Cardiovascular riskfactors and mortality in hospitalized patients with COVID-19: systematic review and meta-analysis of 45 studiesand 18,300 patients. BMC Cardiovasc Disord.2021;21(1):23.
  • 6.Zhou F, Yu T, Du R, et al. Clinical course and risk factorsfor mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet.2020;395(10229):1054-62.
  • 7.Dessie ZG, Zewotir T. Mortality-related risk factors ofCOVID-19: a systematic review and meta-analysis of 42studies and 423,117 patients. BMC Infect Dis.2021;21(1):855.
  • 8.Armstrong RA, Kane AD, Kursumovic E, Oglesby FC,Cook TM. Mortality in patients admitted to intensive carewith COVID-19: an updated systematic review and meta-analysis of observational studies. Anaesthesia. 2021;76(4):537-48.
  • 9. Armstrong RA, Kane AD, Cook TM. Decreasing mortalityrates in ICU during the COVID-19 pandemic. Anaesthesia. 2021:76 (3):10.
  • 10.Petrilli CM, Jones SA, Yang J, et al. Factors associatedwith hospital admission and critical illness among 5279people with coronavirus disease 2019 in New York City:prospective cohort study. BMJ. 2020; 369:m1966.
  • 11. Zhao Z, Chen A, Hou W, et al. Prediction model and risk scores of ICU admission and mortality in COVID-19. PLoSOne. 2020; 15(7): e0236618
  • 12.Li X, Marmar T, Xu Q, et al. Predictive indicators ofsevere COVID-19 independent of comorbidities andadvanced age: a nested case-control study. EpidemiolInfect. 2020; 148: e255.
  • 13.Crespi B, Alcock J. Conflicts over calcium and thetreatment of covid-19. Evol Med Public Heal. 2020;2019:149–56.
  • 14.Martha JW, Wibowo A, Pranata R. Hypocalcemia isassociated with severe COVID-19: A systematic reviewand meta-analysis. Diabetes Metab Syndr. 2021;15(1):337–42.
  • 15.Di Filippo L, Formenti AM, Rovere-Querini P, et al.Hypocalcemia is highly prevalent and predictshospitalization in patients with COVID-19. Endocrine.2020; 68(3): 475-8.
  • 16. Cappellini F, Brivio R, Casati M, et al. Low levels of totaland ionized calcium in blood of COVID-19 patients. ClinChem Lab Med. 2020; 58(9): e171–3.
  • 17.Fu Y, Zhu R, Bai T, et al. Clinical Features of COVID-19-Infected Patients With Elevated Liver Biochemistries: AMulticenter, Retrospective Study. Hepatology. 2021;73(4):1509-20.
  • 18.Ni W, Yang X, Yang D, et al. Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19. Crit Care.2020; 24(1): 422.
  • 19.Zhao Y, Zhao Z, Wang Y, et al. Single-Cell RNAExpression Profiling of ACE2, the Receptor of SARS-CoV-2.Am J Respir Crit Care Med. 2021; 203(6):782.
  • 20.Zhang H, Kang Z, Gong H, et al. The digestive system isa potential route of 2019-nCov infection: a bioinformaticsanalysis based on single-cell transcriptomes. Gut 2020;69:1010-18.
  • 21.Huang FY, Peng Y, Huang BT, et al. The correlationbetween serum total bilirubin and outcomes in patientswith different subtypes of coronary artery disease. ClinChim Acta. 2017; 465: 101–5.
  • 22.Boon AC, Bulmer AC, Coombes JS, Fassett RG.Circulating bilirubin and defense against kidney diseaseand cardiovascular mortality: Mechanisms contributingto protection in clinical investigations. Am J Physiol RenalPhysiol. 2014 ; 307(2): 123-36.
  • 23.Wagener FADTG, Pickkers P, Peterson SJ,Immenschuh S, Abraham NG. Targeting the Heme-HemeOxygenase System to Prevent Severe ComplicationsFollowing COVID-19 Infections. Antioxidants. 2020; 9(6):540.
  • 24.Patel JJ, Taneja A, Niccum D, et al. The association ofserum bilirubin levels on the outcomes of severe sepsis. JIntensive Care Med. 2015; 30(1): 23–9.
  • 25.Wu Y, Ren J, Wang G, et al. Direct bilirubin as aprognostic biomarker in enteric fistula patientscomplicated with sepsis: A case-control study. Int J ClinExp Med. 2014; 7(12): 5134–45.
  • 26.Wiśniewska H, Skonieczna-Żydecka K, Parczewski M,et al. Hepatotropic Properties of SARS-CoV-2-PreliminaryResults of Cross-Sectional Observational Study from theFirst Wave COVID-19 Pandemic. J Clin Med. 2021; 10(4):672.
  • 27.Lei F, Liu YM, Zhou F, et al. Longitudinal AssociationBetween Markers of Liver Injury and Mortality in COVID-19 in China. Hepatology. 2020; 72(2): 389–98.
  • 28.Wu J, Shi L, Zhang P, Wang Y, Yang H. Is creatinine anindependent risk factor for predicting adverse outcomesin COVID-19 patients? Transpl Infect Dis. 2021 ; 23(2):e13539
  • 29.Kazemi E, Soldoozi Nejat R, Ashkan F, Sheibani H. Thelaboratory findings and different COVID-19 severities: asystematic review and meta-analysis. Ann Clin MicrobiolAntimicrob. 2021; 20(1): 17.
  • 30.Danwang C, Endomba FT, Nkeck JR, et al. A meta-analysis of potential biomarkers associated with severityof coronavirus disease 2019 (COVID-19). Biomark Res.2020; 8(1): 37.
There are 30 citations in total.

Details

Primary Language English
Subjects Medical Education
Journal Section Original Articles
Authors

Mehmet Ozel

Songül Araç

Hasan Akkoç

Eşref Araç

Publication Date December 29, 2023
Submission Date October 16, 2023
Acceptance Date December 8, 2023
Published in Issue Year 2023

Cite

APA Ozel, M., Araç, S., Akkoç, H., Araç, E. (2023). Independent Predictors of Mortality in ICU Patients with COVID-19. Dicle Tıp Dergisi, 50(4), 470-481. https://doi.org/10.5798/dicletip.1411504
AMA Ozel M, Araç S, Akkoç H, Araç E. Independent Predictors of Mortality in ICU Patients with COVID-19. diclemedj. December 2023;50(4):470-481. doi:10.5798/dicletip.1411504
Chicago Ozel, Mehmet, Songül Araç, Hasan Akkoç, and Eşref Araç. “Independent Predictors of Mortality in ICU Patients With COVID-19”. Dicle Tıp Dergisi 50, no. 4 (December 2023): 470-81. https://doi.org/10.5798/dicletip.1411504.
EndNote Ozel M, Araç S, Akkoç H, Araç E (December 1, 2023) Independent Predictors of Mortality in ICU Patients with COVID-19. Dicle Tıp Dergisi 50 4 470–481.
IEEE M. Ozel, S. Araç, H. Akkoç, and E. Araç, “Independent Predictors of Mortality in ICU Patients with COVID-19”, diclemedj, vol. 50, no. 4, pp. 470–481, 2023, doi: 10.5798/dicletip.1411504.
ISNAD Ozel, Mehmet et al. “Independent Predictors of Mortality in ICU Patients With COVID-19”. Dicle Tıp Dergisi 50/4 (December 2023), 470-481. https://doi.org/10.5798/dicletip.1411504.
JAMA Ozel M, Araç S, Akkoç H, Araç E. Independent Predictors of Mortality in ICU Patients with COVID-19. diclemedj. 2023;50:470–481.
MLA Ozel, Mehmet et al. “Independent Predictors of Mortality in ICU Patients With COVID-19”. Dicle Tıp Dergisi, vol. 50, no. 4, 2023, pp. 470-81, doi:10.5798/dicletip.1411504.
Vancouver Ozel M, Araç S, Akkoç H, Araç E. Independent Predictors of Mortality in ICU Patients with COVID-19. diclemedj. 2023;50(4):470-81.