Experience of a Training and Research Hospital in the First Wave of the COVID-19 Pandemic; Risk Factors Associated with the Need for Intensive Care/COVID-19 Pandemisinin Ilk Dalgasinda Bir Egitim ve Arastirma Hastanesi Deneyimi: Yogun Bakim Ihtiyaci ile Iliskili Risk Faktorleri

• Published in: KLIMIK dergisi Vol. 34; no. 3; p. 198
• Main Authors: Altunal, Lutfiye Nilsun, Aydin, Mehtap, Ozel, Ayse Serra, Cam, Gulsum, Guclu, Kader Gorkem
• Format: Journal Article
• Language: English
• Published: DOC Design and Informatics Co. Ltd 01-12-2021
• Subjects: Bacterial pneumonia; Comorbidity; Epidemics; Medical research; Medicine, Experimental; Mortality; Pneumonia; Risk factors
• ISSN: 1301-143X
• DOI: 10.36519/kd.2021.3927

Objective: In this study, we aimed to determine the characteristics of patients with COVID-19 pneumonia who were hospitalized in our hospital in the first wave of the pandemic and the factors affecting the need for intensive care. Methods: Patients aged 18 years and older, hospitalized with the diagnosis of COVID-19 between 01/04/202030/06/2020 were included in the study. Demographic and clinical characteristics of the patients were reviewed retrospectively from their files. Multivariate logistic regression analysis was performed to evaluate the factors predicting the need for intensive care. Results: A total of 143 patients with COVID-19 pneumonia were included in the study. Eighty-nine of the patients (62.2%) were male; the mean age was 59[+ or -]15 years. 59.2% of the patients had at least one comorbidity. Thirty-nine (27.2%) patients developed the need for intensive care during their follow-up. Ferritin>400ng/ml (p:0.003, odds ratio-OR:15.2, 95% confidence interval- CI:2.479-93.2), severe involvement on thorax computed tomography (CT) (p:0.0, OR:44.92, 95% CI:5.681-355.3) were independent risk factors affecting the need for intensive care. The mortality rate was 23.1% in all patients included in the study, and the mortality rate was 84.6% in patients who needed intensive care. Conclusions: In addition to typical pneumonia symptoms, ferritin values, thorax CT findings, can be used as indicators to distinguish patients who may need intensive care at an early stage. Considering these risks at the time of admission in the management of patients hospitalized with COVID-19 will lead to better results. Keywords: COVID-19 pandemic, need for intensive care, risk factors Amac: Bu calismada, pandeminin ilk dalgasinda hastanemizde yatirilarak takip edilen COVID-19 pnomonili hastalarin ozelliklerini ve ayni zamanda yogun bakim ihtiyacim etkileyen faktorleri belirlemeyi amacladik. Yontemler: Calismaya, 01 Nisan 2020-30 Haziran 2020 tarihleri arasinda COVID-19 tanisi ile hastanede yatan, 18 yas ve ustu hastalar dahil edildi. Hastalarin demografik ve klinik ozellikleri dosyalarindan retrospektif olarak incelendi. Yogun bakim ihtiyacini ongoren faktorleri degerlendirmek icin cok degiskenli lojistik regresyon analizi yapildi. Bulgular: COVID-19 pnomonisi olan toplam 143 hasta calismaya dahil edildi. Hastalarin 89 (%62.2)'u erkek, yas ortalamasi 59[+ or -]15 olup %59.2'sinde en az bir komorbidite vardi. Takiplerinde yogun bakim ihtiyaci gelisen 39 (%27.2) hasta oldu. Yogun bakim ihtiyacini etkileyen bagimsiz risk faktorleri olarak; ferritin>400ng/ml (p:0.003, "odds ratio" OR:15.2, %95 guven araligi GA:2.479- 93.2), toraks bilgisayarli tomografide (BT) agir tutulum (p:0.0, OR:44.92, %95 GA:5.681- 355.3) saptandi. Calismaya dahil edilen tum hastalarda mortalite orani %23.1; yogun bakim ihtiyaci olan hastalarda ise %84.6 olarak saptandi. Sonuclar: Tipik pnomoni belirtilerine ek olarak, yogun bakim ihtiyaci gelisebilecek hastalari erken evrede ayirt etmek icin; ferritin degeri, toraks BT bulgusu gosterge olarak kullanilabilir. COVID-19 tanisi ile hastaneye yatirilan hastalarin yonetiminde basvuru sirasindaki bu riskleri de dikkate almak daha iyi sonuclar alinmasini saglayacaktir. Anahtar Kelimeler: COVID-19 pandemisi, yogun bakim ihtiyaci, risk faktorleri