Abstract
Background
The aim of this study was to describe and compare clinical characteristics and outcomes in critically ill septic patients with and without COVID-19.
Methods
From February 2020 to March 2021, patients from surgical and medical ICUs at the University Hospital Dresden were screened for sepsis. Patient characteristics and outcomes were assessed descriptively. Patient survival was analyzed using the Kaplan-Meier estimator. Associations between in-hospital mortality and risk factors were modeled using robust Poisson regression, which facilitates derivation of adjusted relative risks.
Results
In 177 ICU patients treated for sepsis, COVID-19 was diagnosed and compared to 191 septic ICU patients without COVID-19. Age and sex did not differ significantly between sepsis patients with and without COVID-19, but SOFA score at ICU admission was significantly higher in septic COVID-19 patients. In-hospital mortality was significantly higher in COVID-19 patients with 59% compared to 29% in Non-COVID patients. Statistical analysis resulted in an adjusted relative risk for in-hospital mortality of 1.74 (95%-CI=1.35–2–24) in the presence of COVID-19 compared to other septic patients. Age, procalcitonin maximum value over 2 ng/ml, need for renal replacement therapy, need for invasive ventilation and septic shock were identified as additional risk factors for in-hospital mortality.
Conclusion
COVID-19 was identified as independent risk factor for higher in-hospital mortality in sepsis patients. The need for invasive ventilation and renal replacement therapy as well as the presence of septic shock and higher PCT should be considered to identify high-risk patients.
【저자키워드】 Coronavirus disease 2019, acute respiratory distress syndrome, intensive care unit, C-reactive protein, procalcitonin, Acute kidney injury, lactate dehydrogenase, Relative risk, interleukin 6, Cytokine release syndrome, extracorporeal membrane oxygenation, body mass index, renal replacement therapy, Hospital acquired infection, COVID-19coronavirus disease 2019, WHOWorld Health Organization, World Health Organization, ICUIntensive Care Unit, ARDSacute respiratory distress syndrome, CRPC-reactive protein, Inhaled nitric oxide, LDHlactate dehydrogenase, BMIbody mass index, CIconfidence interval, confidence interval, sequential organ failure assessment score, ECMOextracorporeal membrane oxygenation, IL-6interleukin 6, CRScytokine release syndrome, AKIAcute Kidney Injury, HAIHospital acquired infection, iNOInhaled nitric oxide, PCTProcalcitonin, RRRelative risk, RRTRenal replacement therapy, SOFA scoreSequential organ failure assessment score, 【초록키워드】 COVID-19, Mortality, Clinical characteristics, Sex, Sepsis, surgical, outcome, risk factor, invasive ventilation, survival, Critically ill, Characteristics, Patient, ICU admission, Septic shock, university, patients, in-hospital mortality, COVID-19 patients, High-risk patients, Analysis, COVID-19 patient, SOFA score, adjusted relative risk, independent risk factor, Poisson regression, sepsis patients, Kaplan-Meier estimator, PCT, ICU patient, medical icu, septic patients, robust, Result, not differ, analyzed, identify, significantly, diagnosed, screened, facilitate, treated, adjusted, significantly higher, sepsis patient, septic patient, were assessed, 【제목키워드】 COVID-19, outcome, sepsis patient,