Predictive factors of six-week mortality in critically ill patients with SARS-CoV-2: A multicenter prospective study.
Corticoides
Corticosteroids
ICU
Lopinavir/ritonavir
SARS-CoV-2
Tocilizumab
UCI
Journal
Medicina intensiva
ISSN: 2173-5727
Titre abrégé: Med Intensiva (Engl Ed)
Pays: Spain
ID NLM: 101717568
Informations de publication
Date de publication:
08 Mar 2021
08 Mar 2021
Historique:
received:
28
12
2020
revised:
19
02
2021
accepted:
22
02
2021
pubmed:
5
4
2021
medline:
5
4
2021
entrez:
4
4
2021
Statut:
aheadofprint
Résumé
The objective of the study is to identify the risk factors associated with mortality at six weeks, especially by analyzing the role of antivirals and munomodulators. Prospective descriptive multicenter cohort study. 26 Intensive care units (ICU) from Andalusian region in Spain. Consecutive critically ill patients with confirmed SARS-CoV-2 infection were included from March 8 to May 30. None. Variables analyzed were demographic, severity scores and clinical condition. Support therapy, drug and mortality were analyzed. An univariate followed by multivariate Cox regression with propensity score analysis was applied. 495 patients were enrolled, but 73 of them were excluded for incomplete data. Thus, 422 patients were included in the final analysis. Median age was 63 years and 305 (72.3%) were men. ICU mortality: 144/422 34%; 14 days mortality: 81/422 (19.2%); 28 days mortality: 121/422 (28.7%); 6-week mortality 152/422 36.5%. By multivariable Cox proportional analysis, factors independently associated with 42-day mortality were age, APACHE II score, SOFA score at ICU admission >6, Lactate dehydrogenase at ICU admission >470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission <6.5%, and thrombocytopenia whereas the use of lopinavir/ritonavir was a protective factor. Age, APACHE II, SOFA>value of 6 points, along with vasopressor requirements or renal replacement therapy have been identified as predictor factors of mortality at six weeks. Administration of corticosteroids showed no benefits in mortality, as did treatment with tocilizumab. Lopinavir/ritonavir administration is identified as a protective factor.
Identifiants
pubmed: 33812670
pii: S0210-5691(21)00033-4
doi: 10.1016/j.medin.2021.02.013
pmc: PMC7938739
pii:
doi:
Types de publication
Journal Article
Langues
eng
spa
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2021 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.
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