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Evaluation of general characteristics of patients diagnosed with COVID-19 who were admitted to the ward and intensive care unit from the emergency department: a retrospective clinical study

Year 2024, Volume: 7 Issue: 4, 444 - 450, 30.07.2024
https://doi.org/10.32322/jhsm.1500135

Abstract

Aims: COVID-19 has caused many negative biological and psychological effects all over the world for a long time. Our aim is to present the general characteristics of patients who were diagnosed with COVID-19 by applying to the emergency department and who were admitted to the intensive care unit or service.
Methods: 1210 patients who were hospitalized in the emergency department, treated between 1 June 2020 and 1 January 2021, who had a positive COVID-19 Polymerase Chain Reaction test result and were examined retrospectively, were included in the study. p<0.05 was considered statistically significant.
Results: While the median age of patients admitted to the intensive care unit was 76, the median age of patients admitted to the service was 65 (p<0.001). The frequency of comorbidity rate in patients in intensive care was significantly higher than in the service. The most common symptoms were shortness of breath and cough. While lymphocyte and albumin levels were significantly lower in patients hospitalized in intensive care, white blood cell, C-reactive protein, procalcitonin, troponin I, D-dimer, urea, creatinine, and fibrinogen levels were significantly higher. When evaluated radiologically, the rate of lung CT retention was more common in patients hospitalized in intensive care.
Conclusion: This study determined that advanced age, the presence of comorbidities, high white blood cell, C-reactive protein, D-dimer, procalcitonin, urea, creatinine, and fibrinogen levels, low lymphocyte, albumin levels, and radiological involvement were also higher in patients admitted to intensive care.

Ethical Statement

Ankara Bilkent City Hospital Ethics Committee with approval number E1-21-2241.

Supporting Institution

None

Thanks

None

References

  • Cintron SA, Hitchcock S, Shen Q, Kasuske L, Yang FM, Pierce J. Symptom science and post-COVID-19 conditions. J Med Surg Pub Health. 2024:100092.
  • Peng P, Liao Y. Six addiction components of problematic social media use in relation to depression, anxiety, and stress symptoms: a latent profile analysis and network analysis. BMC Psychiatry. 2023;23:321.
  • Wang H, Paulson KR, Pease SA, et al. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020-21. Lancet. 2022;399:1513-1536
  • Ahmad FB, Anderson RN . The leading causes of death in the US for 2020. Jama. 2021;325(18):1829-1830.
  • World Health Organization (WHO). Date of access:17 Mart 2024. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
  • Şenyiğit A. COVID-19 pandemisi. Klinik, tanı, tedavi ve korunma. Dicle Tıp Derg. 2021;48:176-186.
  • Okutucu B, Pehlivan S. Reverz-transkriptaz polimeraz zincir reaksiyonu (RT-PCR) ve uygulama alanları. aktd. 2003;12(2).
  • Azmamedova İ, Bahtiyar N, Cinemre FB, Aydemir B. COVID-19’un etiyopatogenezinde hemoteolojik parametrelerin önemi. İstanbul Gelişim Üni Sağ Bilim Derg. 2023;20:724-734.
  • Li B, Li X, Wang Y, et al. Diagnostic value and key features of computed tomography in coronavirus disease 2019. Emerg Microbes Infec. 2020;9(1):787-793.
  • Bernheim A, Mei X, Huang M, et al. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology. 2020;295:200463.
  • Li K, Wu J, Wu F, et al. The clinical and chest CT features associated with severe and critical COVID-19 pneumonia. Investigative Radiology. 2020;55(6):327-331.
  • Türkiye Cumhuriyeti Sağlık Bakanlığı 2 Nisan 2020 COVID-19 (Sars-Cov-2 Enfeksiyonu) Rehberi. Date of access:17 Mart 2024. https://COVID-19.saglik.gov.tr
  • Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506. https://doi.org/10.1016/S0140-6736 (20)30183-5
  • Hocanlı İ, Kabak M. Yoğun bakım ve serviste takip edilen PCR pozitif COVİD 19 tanılı hastaların genel özelliklerinin karşılaştırılması. Van Tip Derg. 2021;28:(2).
  • Bastug A, Bodur H, Erdogan S, et al. Clinical and laboratory features of COVID-19: predictors of severe prognosis. Int Immunopharma. 2020;88:106950.
  • Pijls BG, Jolani S, Atherley A, et al. Demographic risk factors for COVID-19 infection, severity, ICU admission and death: a meta-analysis of 59 studies. BMJ Open. 2021;11:e044640.
  • Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069. doi: 10.1001/jama.2020.1585
  • Zhou Y, Yang Q, Chi J, et al. Comorbidities and the risk of severe or fatal outcomes associated with coronavirus disease 2019: a systematic review and meta-analysis. Int J Infect Dis. 2020;99:47-56.
  • Centers for disease control and prevention. Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19). 2020 (https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html)
  • Smadja DM, Bory OM, Diehl JL, et al. Daily monitoring of d-dimer allows outcomes prediction in COVID-19. TH Open. 2022;6(01):21-25.
  • Zhang L, Yan X, Fan Q, et al. D-dimer levels on admission to predict inhospital mortality in patients with COVID-19. J Thromb Haemost. 2020;18(6):1324-1329.
  • Sui J, Noubouossie DF, Gandotra S, Cao L. Elevated plasma fibrinogen is associated with excessive inflammation and disease severity in COVID-19 patients. Front Cell Infec Micro. 2021;11:734005.
  • Mehrdad R, Zahra K, Mansouritorghabeh H. Hemostatic system (Fibrinogen level, D-Dimer, and FDP) in severe and non-severe patients with COVID-19: a systematic review and meta-analysis. Clin Appl Thromb Hemost. 2021;27:10760296211010973.
  • Cau R, Falaschi Z, Paschè A, et al. Ct Findings of COVID-19 pneumonia in icu-patients. J Public Health Res. 2021:10(3). doi: 10.4081/jphr.2021.2270

Acil servisten COVİD-19 servis ve yoğun bakım ünitesine başvuran, COVİD-19 tanısı alan hastaların genel özelliklerinin değerlendirilmesi: retrospektif bir klinik çalışma

Year 2024, Volume: 7 Issue: 4, 444 - 450, 30.07.2024
https://doi.org/10.32322/jhsm.1500135

Abstract

Amaç: COVİD-19 uzun süre bir süre boyunca tüm dünyada birçok olumsuz biyolojik ve psikolojik etkiye neden olmuştur.Amacımız acil servise başvurarak COVİD-19 tanısı alıp yoğun bakım ünitesine veya servise yatışı yapılan hastaların genel özelliklerini sunmaktır.
Yöntem : Çalışmaya 1 Haziran 2020 ile 1 Ocak 2021 tarihleri arasında acil serviden hastaneye yatırılarak tedavi edilen, COVİD-19 Polimeraz Zincir Reaksiyonu testi pozitif olan ve retrospektif olarak incelenen 1210 hasta dahil edildi. p<0,05 istatistiksel olarak anlamlı kabul edildi.
Bulgular: Yoğun bakım ünitesine kabul edilen hastaların ortanca yaşı 76 iken, servise kabul edilen hastaların ortanca yaşı 65 idi (p<0,001). Yoğun bakımda takip edilen hastalarda komorbidite sıklığı serviste takip edilen hastalara göre anlamlı derecede yüksekti. En sık görülen semptomlar nefes darlığı ve öksürüktü. Yoğun bakımda yatan hastalarda lenfosit ve albümin düzeyleri anlamlı olarak düşük bulunurken; beyaz kan hücresi, C-reaktif protein, prokalsitonin, troponin I, D-dimer, üre, kreatinin ve fibrinojen düzeyleri anlamlı derecede yüksekti. Radyolojik olarak değerlendirildiğinde, yoğun bakımda yatan hastalarda akciğer BT retansiyonu oranı daha fazlaydı.
Sonuç: Bu çalışmada yoğun bakıma kabul edilen hastalarda ileri yaş, kronik hastalıkların varlığı, yüksek beyaz kan hücresi, C-reaktif protein, D-dimer, prokalsitonin, üre, kreatinin ve fibrinojen düzeyleri ile düşük lenfosit, albümin düzeyleri ve radyolojik tutulum fazlalığı anlamlı olarak belirlendi.

References

  • Cintron SA, Hitchcock S, Shen Q, Kasuske L, Yang FM, Pierce J. Symptom science and post-COVID-19 conditions. J Med Surg Pub Health. 2024:100092.
  • Peng P, Liao Y. Six addiction components of problematic social media use in relation to depression, anxiety, and stress symptoms: a latent profile analysis and network analysis. BMC Psychiatry. 2023;23:321.
  • Wang H, Paulson KR, Pease SA, et al. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020-21. Lancet. 2022;399:1513-1536
  • Ahmad FB, Anderson RN . The leading causes of death in the US for 2020. Jama. 2021;325(18):1829-1830.
  • World Health Organization (WHO). Date of access:17 Mart 2024. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
  • Şenyiğit A. COVID-19 pandemisi. Klinik, tanı, tedavi ve korunma. Dicle Tıp Derg. 2021;48:176-186.
  • Okutucu B, Pehlivan S. Reverz-transkriptaz polimeraz zincir reaksiyonu (RT-PCR) ve uygulama alanları. aktd. 2003;12(2).
  • Azmamedova İ, Bahtiyar N, Cinemre FB, Aydemir B. COVID-19’un etiyopatogenezinde hemoteolojik parametrelerin önemi. İstanbul Gelişim Üni Sağ Bilim Derg. 2023;20:724-734.
  • Li B, Li X, Wang Y, et al. Diagnostic value and key features of computed tomography in coronavirus disease 2019. Emerg Microbes Infec. 2020;9(1):787-793.
  • Bernheim A, Mei X, Huang M, et al. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology. 2020;295:200463.
  • Li K, Wu J, Wu F, et al. The clinical and chest CT features associated with severe and critical COVID-19 pneumonia. Investigative Radiology. 2020;55(6):327-331.
  • Türkiye Cumhuriyeti Sağlık Bakanlığı 2 Nisan 2020 COVID-19 (Sars-Cov-2 Enfeksiyonu) Rehberi. Date of access:17 Mart 2024. https://COVID-19.saglik.gov.tr
  • Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506. https://doi.org/10.1016/S0140-6736 (20)30183-5
  • Hocanlı İ, Kabak M. Yoğun bakım ve serviste takip edilen PCR pozitif COVİD 19 tanılı hastaların genel özelliklerinin karşılaştırılması. Van Tip Derg. 2021;28:(2).
  • Bastug A, Bodur H, Erdogan S, et al. Clinical and laboratory features of COVID-19: predictors of severe prognosis. Int Immunopharma. 2020;88:106950.
  • Pijls BG, Jolani S, Atherley A, et al. Demographic risk factors for COVID-19 infection, severity, ICU admission and death: a meta-analysis of 59 studies. BMJ Open. 2021;11:e044640.
  • Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069. doi: 10.1001/jama.2020.1585
  • Zhou Y, Yang Q, Chi J, et al. Comorbidities and the risk of severe or fatal outcomes associated with coronavirus disease 2019: a systematic review and meta-analysis. Int J Infect Dis. 2020;99:47-56.
  • Centers for disease control and prevention. Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19). 2020 (https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html)
  • Smadja DM, Bory OM, Diehl JL, et al. Daily monitoring of d-dimer allows outcomes prediction in COVID-19. TH Open. 2022;6(01):21-25.
  • Zhang L, Yan X, Fan Q, et al. D-dimer levels on admission to predict inhospital mortality in patients with COVID-19. J Thromb Haemost. 2020;18(6):1324-1329.
  • Sui J, Noubouossie DF, Gandotra S, Cao L. Elevated plasma fibrinogen is associated with excessive inflammation and disease severity in COVID-19 patients. Front Cell Infec Micro. 2021;11:734005.
  • Mehrdad R, Zahra K, Mansouritorghabeh H. Hemostatic system (Fibrinogen level, D-Dimer, and FDP) in severe and non-severe patients with COVID-19: a systematic review and meta-analysis. Clin Appl Thromb Hemost. 2021;27:10760296211010973.
  • Cau R, Falaschi Z, Paschè A, et al. Ct Findings of COVID-19 pneumonia in icu-patients. J Public Health Res. 2021:10(3). doi: 10.4081/jphr.2021.2270
There are 24 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Original Article
Authors

Nihal Ertürk 0009-0009-9800-6323

Habibe Selmin Özensoy 0000-0001-9261-2669

Neslihan Yarkın 0009-0003-7476-9648

Edip Varan 0000-0003-1018-8783

Publication Date July 30, 2024
Submission Date June 12, 2024
Acceptance Date July 18, 2024
Published in Issue Year 2024 Volume: 7 Issue: 4

Cite

AMA Ertürk N, Özensoy HS, Yarkın N, Varan E. Evaluation of general characteristics of patients diagnosed with COVID-19 who were admitted to the ward and intensive care unit from the emergency department: a retrospective clinical study. J Health Sci Med / JHSM. July 2024;7(4):444-450. doi:10.32322/jhsm.1500135

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