Gazi Yasargil Training and Research Hospital, located in Diyarbakır province in southeastern Turkey, was designed as a pandemic hospital from the beginning of the coronavirus disease-2019 (COVID-19) outbreak. The first cases in this region were seen on March 22, 2020. In this study, it is aimed to retrospectively examine critical patients admitted to the intensive care unit (ICU) due to COVID-19 from the first onset of cases until September 01, 2020 and to examine the factors affecting mortality. The necessary permits for the study were obtained from the Scientific Research Platform of the T.R. Ministry of Health and the Ethics Committee of the Gazi Yasargil educational and Research Hospital in Diyarbakır. (No: 550, 11.09.2020) Patients diagnosed with COVID-19 on the specified dates, followed in the ICU, older than 18 years, identified as critical/serious according to the World Health Organization and provisional guidelines of the Scientific Board of the T.R. Ministry of Health will be included in the study. ICU patients without COVID-19; COVID-19 patients under 18 years of age; COVID-19 patients with mild to moderate symptoms, no respiratory distress, no signs of common pneumonia on lung radiography or tomography will be excluded from the study. Patients' age, gender, comorbidity, Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) and Kidney Disease: Improving Global Outcomes (KDIGO) scores when first admitted to the ICU, hemogram parameters (white blood cell count, neutrophil, lymphocyte, neutrophil / lymphocyte ratio, hemoglobin, hematocrit, platelet count), blood gas information (pH, Partial oxygen pressure-PO2, Partial pressure of carbon dioxide-PCO2, bicarbonate-HCO3, lactate), coagulation parameters (prothrombin time and D-dimer, blood biochemistry results (C-reactive protein, lactate dehydrogenase, creatine kinase , urea, creatinine, alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin and indirect bilirubin), procalcitonin and ferritin levels will be recorded. In addition, the number of days spent in the ICU and whether mortality develops or not will be recorded. Patients will be divided into two groups according to their clinical results as those without mortality during ICU follow-up (Group S) and those with mortality (Group NS). The clinical characteristics of both groups, APACHE II, SOFA, KDIGO scores and laboratory results at the first admission to the ICU will be compared. With the diagnosis of COVID-19, factors affecting mortality in critical patients in the ICU will be tried to be determined.
Study Type
OBSERVATIONAL
Enrollment
445
Patients' age, gender, comorbidity, APACHE II, SOFA and KDIGO scores when first admitted to the ICU, performing hemogram (WBC, neutrophil, lymphocyte, neutrophil / lymphocyte ratio, hemoglobin, hematocrit, platelet count), blood gas information (pH, PO2, PCO2, HCO3, lactate), coagulation parameters PTZ and D-dimer, blood biochemistry results (CRP, LDH, CK, urea, creatinine, ALT, AST, total bilirubin, direct bilirubin and indirect bilirubin), procalcitonin and ferritin levels will be recorded. In addition, the number of days spent in the ICU and whether mortality develops or not will be recorded.
Diyarbakır Gazi Yaşargil Training and Research Hospital
Diyarbakır, Turkey (Türkiye)
Acute Physiology and Chronic Health Evaluation II Score
The score can help in the assessment of patients to determine the level \& degree of diagnostic \& therapeutic intervention. Interpretation of APACHE II: minimum 0 and maximum 71; increasing score is associated with an increasing risk of hospital death.
Time frame: APACHE II score on the first admission of ICU
Sequential Organ Failure Assessment Score
The Sequential Organ Failure Assessment (SOFA) score is a scoring system that assesses the performance of several organ systems in the body (neurologic, blood, liver, kidney, and blood pressure/hemodynamics) and assigns a score based on the data obtained in each category. The SOFA score is made of 6 variables, each representing an organ system. Each organ system is assigned a point value from 0 (normal) to 4 (high degree of dysfunction/failure). Score ranges from 0 (best) to 24 (worst) points.
Time frame: SOFA score on the first admission of ICU
Kidney Disease: Improving Global Outcomes Scores
It is a system used to determine the severity of kidney failure. It is a classification consisting of four stages: 0-1-2-3. It indicates that the level of failure worsens as the stage increases.
Time frame: When the patients were admitted to ICU for the first time.
White Blood Cell
White blood cell count was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission
Neutrophil
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: When the patients were admitted to ICU for the first time
Lymphocyte
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: When the patients were admitted to ICU for the first time
Neutrophil Lymphocyte Ratio
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: the first admission to ICU
Comorbidities
The presence of this comorbidity was determined based on medical history documented in medical records at ICU admission.
Time frame: When the patients were admitted to ICU for the first time
Diabetes
The presence of this comorbidity was determined based on medical history documented in medical records at ICU admission.
Time frame: When the patients were admitted to ICU for the first time
Hypertension
The presence of this comorbidity was determined based on medical history documented in medical records at ICU admission.
Time frame: When the patients were admitted to ICU for the first time
Chronic Obstructive Pulmonary Disease
The presence of this comorbidity was determined based on medical history documented in medical records at ICU admission.
Time frame: When the patients were admitted to ICU for the first time
Chronic Kidney Disease
The presence of this comorbidity was determined based on medical history documented in medical records at ICU admission.
Time frame: When the patients were admitted to ICU for the first time
Cardiovascular Disease
The presence of this comorbidity was determined based on medical history documented in medical records at ICU admission.
Time frame: When the patients were admitted to ICU for the first time
Hemoglobin
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Hematocrit
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Platelet
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Prothrombin Time
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
D-dimer
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Blood Gas Analysis-pH
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Partial Oxygen Pressure
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Partial Pressure of Carbon Dioxide
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Bicarbonate
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Lactate
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Lactate Dehydrogenase
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Creatine Kinase
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
C-reactive Protein
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Blood Urea Nitrogen
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Creatinine
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Alanine Aminotransferase
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Aspartate Aminotransferase
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Total Bilirubin
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Direct Bilirubin
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Indirect Bilirubin
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Procalcitonin
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Ferritin
This parameter was measured using routinely collected laboratory data obtained from medical records at ICU admission.
Time frame: At ICU admission (first laboratory measurement after ICU admission)
Length of Stay in the Intensive Care Unit
ICU length of stay was measured as the total number of days from ICU admission to ICU discharge or death, based on information recorded in medical records.
Time frame: Three months
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