Characteristics and outcomes of critically ill patients with covid-19 in Sakarya, Turkey: a single centre cohort study

Turk J Med Sci. 2021 Apr 30;51(2):440-447. doi: 10.3906/sag-2005-57.

Abstract

Background/aim: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Turkey on March 10, 2020 and the number of the patients are increasing day by day. Coronavirus disease 2019 (Covid-19) has high mortality rates in intensive care units (ICUs). We aimed to describe the demographic characteristics, comorbidities, treatment protocols, and clinical outcomes among the critically ill patients admitted to the ICU of our hospital.

Materials and methods: This cohort study included 103 consecutive patients who had laboratory confirmed Covid-19 and admitted to ICU of Sakarya University Training and Research Hospital between March 19 and April 13, 2020. The final date of the follow-up was April 18.

Results: The mean age of the patients was 69.6 ± 14.1 years. Most of the patients had increased CRP (99%), serum ferritin (73.8%), d-dimer (82.5%), and hs-troponin levels (38.8%). 34 patients (33%) had lymphocytopenia, 24 patients (23.3%) had thrombocytopenia. 63 patients (61.2%) developed acute respiratory distress syndrome (ARDS), 31 patients (30.1%) had acute kidney injury, and 52 patients (50.5%) had multiple organ dysfunction syndrome (MODS) during follow-up. Sixty-two patients (60.2%) received mechanical ventilation. As of April 18, of the 103 patients, 52 (50.5%) had died, 30 (29.1%) had been discharged from the ICU, 21 (20.4%) were still in the ICU.

Conclusions: Covid-19 has high mortality rates in ICU. Patients with elevated procalcitonin, hs-troponin, d-dimer, and CRP levels and lower platelet count at admission have higher mortality.

Keywords: intensive care unit; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); coronavirus disease 2019 (Covid-19).

MeSH terms

  • Acute Kidney Injury / physiopathology*
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use
  • C-Reactive Protein / metabolism
  • COVID-19 / metabolism
  • COVID-19 / mortality
  • COVID-19 / physiopathology*
  • COVID-19 / therapy
  • Cohort Studies
  • Continuous Renal Replacement Therapy
  • Critical Illness
  • Female
  • Ferritins / metabolism
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Glucocorticoids / therapeutic use
  • Hospital Mortality
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Lymphopenia / blood
  • Male
  • Middle Aged
  • Multiple Organ Failure / physiopathology*
  • Oxygen Inhalation Therapy
  • Platelet Count
  • Procalcitonin / metabolism
  • Prognosis
  • Respiration, Artificial
  • Respiratory Distress Syndrome / physiopathology*
  • Respiratory Insufficiency / physiopathology*
  • Respiratory Insufficiency / therapy
  • SARS-CoV-2
  • Severity of Illness Index
  • Thrombocytopenia / blood
  • Troponin / metabolism
  • Turkey

Substances

  • Antiviral Agents
  • Fibrin Fibrinogen Degradation Products
  • Glucocorticoids
  • Procalcitonin
  • Troponin
  • fibrin fragment D
  • C-Reactive Protein
  • Ferritins