Comorbidities as Risk Factors for Mortality in COVID-19 Acute Respiratory Distress Syndrome Adult Patients: A Single-Center Retrospective Study

Background: Geriatric, obesity, and chronic disease are classified as risk factors for adverse outcomes of coronavirus disease 2019 (COVID-19). Studies regarding the importance of these comorbidities in COVID-19 with severe complications such as acute respiratory distress syndrome (ARDS) are scarce. This study aims to analyze age, obesity, and chronic disease comorbidities as risk factors for 28-days mortality in COVID-19 patients with ARDS. Methods: A retrospective, single-center study was conducted in Dr. Soetomo General Hospital, Surabaya, Indonesia between July-October 2020. We included all adult inpatients (≥18 years old) of confirmed COVID-19 with ARDS. Demographic, comorbidities, initial PaO2/FiO2 ratio, time of discharge or death were obtained from medical records and compared the ARDS severity between survivors and non-survivors. The univariate and multivariate logistic regression methods were used to identify risk factors associated with in-hospital death. Result: Among 102 patients of COVID-19 with ARDS, the median age is 52 years. Most of them are within 50 – 59 age categories. The median hospital length of stay (LOS) for survivor is 22 (15.7 – 26) days and 9 (4.25 – 14.4) days for non-survivor. The 28-days mortality rate is 48 (47.1%) patients. Age > 65 years old (HR= 2.7, 95% CI 1.39 – 5.44, p value= 0.004), obesity (HR= 2.2, 95% CI 1.16 – 4.51, p value= 0.016), and chronic hypertension (HR= 1.98, 95% CI 1.11 – 3.52, p value= 0.02) are the independent risk factors for 28-days mortality in COVID-19 with ARDS. Conclusion: Geriatric, obesity, and chronic hypertension comorbidities are the risk factors for mortality of COVID-19 with ARDS complications.

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Key factors leading to fatal outcomes in COVID-19 patients with cardiac injury

Scientific Reports ◽

10.1038/s41598-021-82396-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yiyu He ◽

Xiaoxin Zheng ◽

Xiaoyan Li ◽

Xuejun Jiang

Keyword(s):

Acute Respiratory Distress Syndrome ◽

High Risk ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Troponin I ◽

Cardiac Injury ◽

Advanced Age ◽

Hospital Death ◽

Key Factors

AbstractCardiac injury among patients with COVID-19 has been reported and is associated with a high risk of mortality, but cardiac injury may not be the leading factor related to death. The factors related to poor prognosis among COVID-19 patients with myocardial injury are still unclear. This study aimed to explore the potential key factors leading to in-hospital death among COVID-19 patients with cardiac injury. This retrospective single-center study was conducted at Renmin Hospital of Wuhan University, from January 20, 2020 to April 10, 2020, in Wuhan, China. All inpatients with confirmed COVID-19 (≥ 18 years old) and cardiac injury who had died or were discharged by April 10, 2020 were included. Demographic data and clinical and laboratory findings were collected and compared between survivors and nonsurvivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with mortality in COVID-19 patients with cardiac injury. A total of 173 COVID-19 patients with cardiac injury were included in this study, 86 were discharged and 87 died in the hospital. Multivariable regression showed increased odds of in-hospital death were associated with advanced age (odds ratio 1.12, 95% CI 1.05–1.18, per year increase; p < 0.001), coagulopathy (2.54, 1.26–5.12; p = 0·009), acute respiratory distress syndrome (16.56, 6.66–41.2; p < 0.001), and elevated hypersensitive troponin I (4.54, 1.79–11.48; p = 0.001). A high risk of in-hospital death was observed among COVID-19 patients with cardiac injury in this study. The factors related to death include advanced age, coagulopathy, acute respiratory distress syndrome and elevated levels of hypersensitive troponin I.

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Prognostic factors for development of acute respiratory distress syndrome following traumatic injury – a systematic review and meta-analysis

European Respiratory Journal ◽

10.1183/13993003.00857-2021 ◽

2021 ◽

pp. 2100857

Author(s):

Alexandre Tran ◽

Shannon M. Fernando ◽

Laurent J. Brochard ◽

Eddy Fan ◽

Kenji Inaba ◽

...

Keyword(s):

Risk Factors ◽

Acute Respiratory Distress Syndrome ◽

Prognostic Factors ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Traumatic Injury ◽

Clinical Risk Factors ◽

Factors Associated ◽

Post Traumatic

PurposeTo summarise the prognostic associations between various clinical risk factors and the development of the acute respiratory distress syndrome (ARDS) following traumatic injury.MethodsWe conducted this review in accordance with the PRISMA and CHARMS guidelines. We searched six databases from inception through December 2020. We included English language studies describing the clinical risk factors associated with the development of post-traumatic ARDS, as defined by either the American-European Consensus Conference or the Berlin definition. We pooled adjusted odds ratios for prognostic factors using the random effects method. We assessed risk of bias using the QUIPS tool and certainty of findings using GRADE methodology.ResultsWe included 39 studies involving 5 350 927 patients. We identified the amount of crystalloid resuscitation as a potentially modifiable prognostic factor associated with the development of post-traumatic ARDS (adjusted odds ratio [aOR] 1.19 for each additional liter of crystalloid administered within first 6 h after injury, 95% CI 1.15 to 1.24, high certainty). Non-modifiable prognostic factors with a moderate or high certainty of association with post-traumatic ARDS included increasing age, non-Hispanic white race, blunt mechanism of injury, presence of head injury, pulmonary contusion, or rib fracture; and increasing chest injury severity.ConclusionWe identified one important modifiable factor, the amount of crystalloid resuscitation within the first 24 h of injury, and several non-modifiable factors associated with development of post-traumatic ARDS. This information should support the judicious use of crystalloid resuscitation in trauma patients and may inform the development of a risk-stratification tools.

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