Abstract
Background: Around 20% of patients hospitalized for COVID-19 need mechanical ventilation (MV). MV may be prolonged, thus warranting tracheostomy.
Methods: Observational cohort study enrolling patients admitted due to COVID-19. Demographic and clinical data at hospital and ICU admission were collected. The primary endpoint was to identify parameters associated with a need for tracheostomy; secondary endpoints were to analyze the clinical course of patients who needed tracheostomy.
Results: 118 patients were enrolled; 37 patients (31.5%) were transferred to ICU, of which 11 (29.72%) needed a tracheostomy due to prolonged MV. Sequential Organ Failure Assessment (SOFA) score at ICU admission (OR 0.65, 95% CI 0.47-0.92, p 0.015) was the only variable found to be associated with increased risk of the need for tracheostomy, with a cut-off point of 4.5 (sensitivity 0.72, specificity 0.73, positive predictive value 0.57 and negative predictive value 0.85). The main complications were nosocomial infection (100%), supraventricular cardiac arrhythmia (45.5%), agitation (54.5%), pulmonary thromboembolism (9.1%) and depression (9.1%). All patients presented with hypoalbuminemia and significant critical illness polyneuropathy.
Conclusion: SOFA at ICU admission is associated with an increased risk of tracheostomy in patients with COVID-19. Moreover, they present clinical features similar to those with chronic critical illness and suffer SARS-CoV-2-related complications.
Keywords: COVID-19; Prolonged mechanical ventilation; Respiratory failure; Tracheostomy.
【저자키워드】 COVID-19, Respiratory failure, tracheostomy, Prolonged mechanical ventilation, 【초록키워드】 Depression, mechanical ventilation, hospital, ICU, cohort study, Cardiac arrhythmia, sensitivity, specificity, Clinical course, Positive predictive value, Patient, Thromboembolism, ICU admission, Nosocomial infection, Complication, complications, SOFA, respiratory, assessment, demographic, Critical, clinical feature, Prolonged, primary endpoint, Negative predictive value, tracheostomy, 95% CI, secondary endpoint, increased risk, failure, Clinical data, cut-off, parameter, Agitation, supraventricular, identify, collected, patients hospitalized, patients with COVID-19, transferred, 【제목키워드】 Patient, predictor, clinical feature, tracheostomy,