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
. 2023 Nov-Dec;39(6):1824-1829.
doi: 10.12669/pjms.39.6.7380.

Frequency of extra pulmonary complications in critically ill COVID-19 patients and their association with inflammatory markers and hypoxia: Retrospective analysis at a tertiary care hospital in Karachi, Pakistan

Sadaf Hanif  1 , Muhammad Sohaib  2 , Syed Talha  3 , Asma Rayani  4
Affiliations

Frequency of extra pulmonary complications in critically ill COVID-19 patients and their association with inflammatory markers and hypoxia: Retrospective analysis at a tertiary care hospital in Karachi, Pakistan

Sadaf Hanif et al. Pak J Med Sci. 2023 Nov-Dec.

Abstract

Background and objective: This study aimed to determine the incidence of extra pulmonary complications among critically ill COVID-19 patients requiring invasive mechanical ventilation and association of these complications with various inflammatory markers and degree of hypoxia.

Methods: A retrospective cohort study was conducted among 173 adults in Karachi having COVID-19 and were admitted to ICU in a tertiary care private hospital between August 2020 to July 2021.

Results: The median age of patients included in the analysis was 61 years (IQR; 16). Acute kidney injury, septic shock, cardiac injury, and electrolytes imbalance were the most frequent extra pulmonary complications with proportion of 65.3% (n=113), 63.6% (n=110), 61.8% (n=107) and 33.5% (n=58). Statistically significant differences in the median serum levels of ferritin were observed among male versus female, critically ill covid patients with and without ICU mortality as well as patients with and without hospital mortality (p-value <0.05). Significantly higher serum levels of d-dimer were noted among patients who developed acute liver injury or NSTEMI, or had ICU stay of > 3 days or received mechanical ventilation for >2 days.

Conclusion: Acute kidney injury, septic shock, cardiac injury, and electrolytes imbalance were the most common extra pulmonary complications among mechanically ventilated COVID-19 patients with ARDS. Higher serum d-dimer levels were associated with acute liver injury, NSTEMI, ICU stay longer >3 days and invasive mechanical ventilation >2 days. Higher serum ferritin levels are associated with male sex and serve as an important predictor of ICU as well as hospital mortality.

Keywords: ARDS; COVID-19; Extra pulmonary complications.

PubMed Disclaimer

Figures

Fig.1
Fig.1
Incidence Proportion for various extrapulmonary complicationsn among critically ill COVID-19 patients admitted with ARDS in COVID-ICU of a private, tertiary care teaching Hospital in Karachi (n =173).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Cho J, Lee J, Sia CH, Koo CS, Tan BY, Hong W, et al. Extra pulmonary manifestations and complications of severe acute respiratory syndrome coronavirus 2 infection:a systematic review. Singapore Med J. 2021;1:1–53. doi:10.11622/smedj.2021100. - PMC - PubMed
    1. Ning Q, Wu D, Wang X, Xi D, Chen T, Chen G, et al. The mechanism underlying extrapulmonary complications of the coronavirus disease 2019 and its therapeutic implication. Signal Transduct. Target Ther. 2022;7(1):1–33. doi:10.1038/s41392-022-00907-1. - PMC - PubMed
    1. Li X, Ma X. Acute respiratory failure in COVID-19:is it “typical”ARDS? Crit Care. 2020;24(1):1–5. doi:10.1186/s13054-020-02911-9. - PMC - PubMed
    1. Tzotzos SJ, Fischer B, Fischer H, Zeitlinger M. Incidence of ARDS and outcomes in hospitalized patients with COVID-19:a global literature survey. Crit Care. 2020;24(1):1–4. doi:10.1186/s13054-020-03240-7. - PMC - PubMed
    1. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020(8):420–422. doi:10.1016/S2213-2600(20)30076-X. - PMC - PubMed

LinkOut - more resources