Intensive care unit: mortality score in early prediction of mortality in critical COVID-19 patients

Abstract

Abstract Aim: The mortality data available in the literature with regard to patients infected with SARS-COV-2, thus requiring hospitalization in the Intensive Care Unit (ICU) are not sufficient. This research aims to compare the correlation between COVID-19 Mortality Ratios (CMR), AST/ALT and neutrophil/lymphocyte (N/L) ratios of non-smoker COVID-19 patients hospitalized in the ICU and their mortality rates. Methods: This cross-sectional study was conducted on 77 patients hospitalized in the ICU. Female participants constituted 64.9% (n = 50) of the study group while male made up 35.1% (n = 27); the mean age was 61.3±14.3 and 66.2% (n = 51) of the patients died. To exclude the adverse effect of smoking on mortality, patients were confirmed to be non-smokers by analyzing the cotinine levels in urine samples. For this purpose, patients' age, gender, comorbidities, fever, pulse, blood pressure, saturation values, APACHE scores and biochemical parameters were evaluated. Results: In the study, 66.2% (n=51) of the patients died during follow-up. Age, urea, creatinine, AST/ALT, N/L ratio and CMR values of the nonsurvivors were significantly higher than those of the survivors. The systolic blood pressure and lymphocyte values of non-survivors were lower than survivors. Conclusions: The conclusion of the study revealed that CMR scores, AST/ALT levels and the N/L ratio can effectively be utilized in early period to project the mortality rates of non (active) smoking patients with critical COVID-19 infection hospitalized in the ICU.

Keywords

• SARS-COV-2,
• intensive care unit,
• COVID-19 mortality ratio,
• cotinine,
• smokers and non-smokers

Yoğun bakım ünitesi: kritik COVID-19 hastalarında mortalitenin erken tahmininde Mortality Score (CMR)

Abstract

Amaç: SARS-COV-2 ile enfekte olup yoğun bakım ünitesinde (YBÜ) yatış gerektiren hastalara ilişkin literatürde yer alan mortalite verileri yeterli değildir. Bu araştırma, yoğun bakımda yatan sigara içmeyen COVID-19 hastalarının COVID-19 Mortalite Oranları (CMR), AST/ALT ve nötrofil/lenfosit (N/L) oranları ile onların mortalite oranları arasındaki korelasyonu karşılaştırmayı amaçlamaktadır. Yöntemler: Bu kesitsel çalışma YBÜ’de yatan 77 hasta üzerinde yapıldı. Çalışma grubunun %64.9'unu (n=50) kadın katılımcılar, %35.1'ini (n=27) erkekler oluşturmuştur; yaş ortalaması 61.3±14.3 olup, hastaların %66.2'si (n=51) ölmüştür. Sigara içmenin mortalite üzerindeki olumsuz etkisini dışlamak için, idrar numunelerindeki kotinin seviyeleri analiz edilerek hastaların sigara içmediği doğrulandı. Bu amaçla hastaların yaşı, cinsiyeti, ek hastalıkları, ateş, nabız, kan basıncı, satürasyon değerleri, APACHE skorları ve biyokimyasal parametreleri değerlendirildi. Bulgular: Çalışmada, hastaların %66.2'si (n=51) takip sırasında öldü. Ölenlerin yaş, üre, kreatinin, AST/ALT, N/L oranı ve CMR değerleri ölmeyenlerden anlamlı olarak yüksekti. Ölenlerin sistolik kan basıncı ve lenfosit değerleri ölmeyenlerden daha düşüktü. Sonuç: Çalışmanın sonucu; YBÜ’de yatan kritik COVID-19 enfeksiyonu olan ve (aktif) sigara içmeyen hastaların ölüm oranlarını tahmin etmek için CMR skorları, AST/ALT seviyeleri ve N/L oranının, erken dönemde etkili bir şekilde kullanılabileceğini ortaya koymuştur.

Keywords

• SARS-COV-2;
• yoğun bakım ünitesi,
• COVID-19 ölüm oranı,
• kotinin,
• sigara içenler ve içmeyenler

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