Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr 20:2021:6648199.
doi: 10.1155/2021/6648199. eCollection 2021.

Predictors of Mortality in Critically Ill COVID-19 Patients Demanding High Oxygen Flow: A Thin Line between Inflammation, Cytokine Storm, and Coagulopathy

Viseslav Popadic  1 , Slobodan Klasnja  1 , Natasa Milic  2   3 , Nina Rajovic  2 , Aleksandra Aleksic  1 , Marija Milenkovic  4   5 , Bogdan Crnokrak  1 , Bela Balint  6   7 , Milena Todorovic-Balint  5   8 , Davor Mrda  1 , Darko Zdravkovic  1   5 , Borislav Toskovic  1   5 , Marija Brankovic  1   5 , Olivera Markovic  1   5 , Jelica Bjekic-Macut  1   5 , Predrag Djuran  1 , Lidija Memon  1 , Milica Brajkovic  1 , Zoran Todorovic  1   5 , Jovan Hadzi-Djokic  5   7 , Igor Jovanovic  1 , Dejan Nikolic  1   5 , Marija Zdravkovic  1   5
Affiliations

Predictors of Mortality in Critically Ill COVID-19 Patients Demanding High Oxygen Flow: A Thin Line between Inflammation, Cytokine Storm, and Coagulopathy

Viseslav Popadic et al. Oxid Med Cell Longev. .

Abstract

Introduction: Mortality among critically ill COVID-19 patients remains relatively high despite different potential therapeutic modalities being introduced recently. The treatment of critically ill patients is a challenging task, without identified credible predictors of mortality.

Methods: We performed an analysis of 160 consecutive patients with confirmed COVID-19 infection admitted to the Respiratory Intensive Care Unit between June 23, 2020, and October 2, 2020, in University Hospital Center Bezanijska kosa, Belgrade, Serbia. Patients on invasive, noninvasive ventilation and high flow oxygen therapy with moderate to severe ARDS, according to the Berlin definition of ARDS, were selected for the study. Demographic data, past medical history, laboratory values, and CT severity score were analyzed to identify predictors of mortality. Univariate and multivariate logistic regression models were used to assess potential predictors of mortality in critically ill COVID-19 patients.

Results: The mean patient age was 65.6 years (range, 29-92 years), predominantly men, 68.8%. 107 (66.9%) patients were on invasive mechanical ventilation, 31 (19.3%) on noninvasive, and 22 (13.8%) on high flow oxygen therapy machine. The median total number of ICU days was 10 (25th to 75th percentile: 6-18), while the median total number of hospital stay was 18 (25th to 75th percentile: 12-28). The mortality rate was 60% (96/160). Univariate logistic regression analysis confirmed the significance of age, CRP, and lymphocytes at admission to hospital, serum albumin, D-dimer, and IL-6 at admission to ICU, and CT score. Serum albumin, D-dimer, and IL-6 at admission to ICU were independently associated with mortality in the final multivariate analysis.

Conclusion: In the present study of 160 consecutive critically ill COVID-19 patients with moderate to severe ARDS, IL-6, serum albumin, and D-dimer at admission to ICU, accompanied by chest CT severity score, were marked as independent predictors of mortality.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
ROC curves for (a) age, (b) serum albumin, (c) IL-6, (d) D-dimer, and (e) CT score.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Coronavirus Cases. Retrieved December 16, 2020, from https://www.worldometers.info/coronavirus/
    1. Lai C. C., Ko W. C., Lee P. I., Jean S. S., Hsueh P. R. Extra-respiratory manifestations of COVID-19. International Journal of Antimicrobial Agents. 2020;56(2):p. 106024. doi: 10.1016/j.ijantimicag.2020.106024. - DOI - PMC - PubMed
    1. Bandyopadhyay D., Akhtar T., Hajra A., et al. COVID-19 pandemic: cardiovascular complications and future implications. American Journal of Cardiovascular Drugs. 2020;20(4):311–324. doi: 10.1007/s40256-020-00420-2. - DOI - PMC - PubMed
    1. Asadi-Pooya A. A., Simani L. Central nervous system manifestations of COVID-19: a systematic review. Journal of the Neurological Sciences. 2020;413, article 116832 doi: 10.1016/j.jns.2020.116832. - DOI - PMC - PubMed
    1. Lee I. C., Huo T. L., Huang Y. H. Gastrointestinal and liver manifestations in patients with COVID-19. Journal of the Chinese Medical Association. 2020;83(6):521–523. doi: 10.1097/JCMA.0000000000000319. - DOI - PMC - PubMed

MeSH terms