Journals / Annals of Medical Research / 2021 / Cilt: 28 - Sayı: 9

Triage and management of probable Covid-19 patients in the intensive care unit during the pandemic period

Pages
1690–1698
Publication Date
2022-10-12
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The overall ICU mortality rate was 44.1%.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: Republic of Turkey Ministry of Health dedicated our hospital as a transplant center during the pandemic period.
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Key Findings & Data:We admitted probable Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infection (COVID-19) cases and intensive care unit (ICU) patients from other centers, while confirmed COVID-19 cases were transferred to dedicated pandemic hospitals.
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Conclusion & Impact:The overall ICU mortality rate was 44.1%.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Aim: Republic of Turkey Ministry of Health dedicated our hospital as a transplant center during the pandemic period. We admitted probable Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infection (COVID-19) cases and intensive care unit (ICU) patients from other centers, while confirmed COVID-19 cases were transferred to dedicated pandemic hospitals. The aim of this study was to determine the demographic parameters, clinical courses and outcomes of probable COVID-19 patients and to compare survivors with non-survivors admitted to our ICU. Materials and Methods: After Ethics Committee approval, 93 patients admitted to our ICU between March 23 and May 13 were analyzed retrospectively. Results: Mean age was 68.5y (60.2% male). Dyspnea (67.7%) was the most common symptom and hypertension (68.6%) was the most common comorbidity. None of PCR tests for SARS-CoV-2 were positive. Bilateral ground-glass (25.8%) and consolidation (14%) were the most common signs at chest computed tomography. Mean Acute Physiology and Chronic Health Evaluation System (APACHE II) score was 20.2 at ICU admission. Fifty-seven patients (61.3%) had pneumonia findings in lung X-ray or computerized tomography (CT). Thirty-four patients (36.6%) received low flow oxygen, six (9.7%) had high flow nasal oxygen and 27 (29%) had invasive mechanical ventilation. Forty patients (43%) had vasopressor therapy and 24 (25.8%) patients had renal replacement therapy due to acute kidney injury. Laboratory data including D-dimer, C-reactive protein, ferritin, creatinine kinase and procalcitonin were significantly higher in non-survivors when compared to survivors. The overall ICU mortality rate was 44.1%. Conclusions: A triage protocol of Turkish Study of Scientific Board based on clinical, laboratory and radiological findings for probable COVID-19 patients was applied in our center during the pandemic period. So, we ensured the effective usage of scarce ICU resources. The mortality rate of probable COVID-19 patients admitted to our ICU was found to be higher than the predicted mortality rate according to their APACHE-II score.

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Cite This Article

Yalcin, T. Y., Yesiler, F. I., Sahinturk, H., Zeyneloglu, P., Kandemir, T., Gedik, E., Kandemir, E., Akmatov, N. (2022). Triage and management of probable Covid-19 patients in the intensive care unit during the pandemic period. Annals of Medical Research, Cilt: 28 - Sayı: 9, 1690–1698. https://ajindex.com/articles/445831

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References (13)

  1. 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
  2. Grasselli G, Pesenti A, Cecconi M. Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response. JAMA 2020;16:1545-46
  3. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020;382:1708-20
  4. World Health Organization. Coronavirus disease (COVID-2019) situation reports.https://www.who. int/emergencies/diseases/novel-coronavirus-2019/ situation-reports 5. World Health Organization. Coronavirus disease (COVID-19) outbreak.
  5. 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;323:1061-9
  6. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study Lancet 2020;395:507-13
  7. Tan W, Zhao X, Ma X, et al. A novel coronavirus genome identified in a cluster of pneumonia cases—Wuhan, China 2019−2020. China CDC Weekly 2020;2:61-2
  8. COVID-19 New Coronavirus Disease, Republic of Turkey, Ministry of Health. https://covid19bilgi.saglik. gov.tr/tr/ 10. Sprung CL, Joynt GM, Christian MD, et al. Adult ICU Triage During the Coronavirus Disease 2019 Pandemic: Who Will Live and Who Will Die? Recommendations to Improve Survival. Crit Care Med 2020;48:1196-202
  9. Republic of Turkey Ministry of Health. General Directorate of Public Health. COVID-19 (SARS-CoV-2) infection guideline,Study of Scientific Board. Ankara, Turkey: Republic of Turkey Ministry of Health; 2020.
  10. World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (2019- nCoV) infection is suspected: interim guidance 13 March 2020. Geneva, Switzerland:WHO; 2020
  11. Alhazzani W, Moller MH, Arabi YM, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med 2020;46:854-87
  12. Garner JS, Jarvis WR, Emori TG, et al. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128-40
  13. Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An