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10.1016/j.ijid.2020.09.012

http://scihub22266oqcxt.onion/10.1016/j.ijid.2020.09.012
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32920232!7484622!32920232
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suck abstract from ncbi


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pmid32920232      Int+J+Infect+Dis 2020 ; 100 (ä): 258-263
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  • Risk factors for non-invasive/invasive ventilatory support in patients with COVID-19 pneumonia: A retrospective study within a multidisciplinary approach #MMPMID32920232
  • Suardi LR; Pallotto C; Esperti S; Tazzioli E; Baragli F; Salomoni E; Botta A; Covani Frigieri F; Pazzi M; Stera C; Carlucci M; Papa R; Meconi T; Pavoni V; Blanc P
  • Int J Infect Dis 2020[Nov]; 100 (ä): 258-263 PMID32920232show ga
  • OBJECTIVES: To investigate risk factors for non-invasive/invasive ventilatory support (NI/I-VS) in patients with coronavirus disease 2019 (COVID-19). METHODS: All consecutive patients admitted to the Infectious Diseases Unit and Intensive Care Unit (ICU) of Santa Maria Annunziata Hospital (Florence, Italy), from February 25 to April 25, 2020, with a confirmed COVID-19 diagnosis were enrolled in this retrospective cohort study. NI/I-VS was defined as the need for continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BPAP) (non-invasive ventilation) or mechanical ventilation, not including low-flow systems of oxygen therapy such as the Venturi mask or nasal cannula. RESULTS: Ninety-seven patients were enrolled; 61.9% (60/97) were male and the median patient age was 64 years. The in-hospital mortality was 9.3%. Thirty-five of the 97 patients (36%) required ICU admission and 94.8% (92/97) were prescribed oxygen therapy: 10.8% (10/92) by nasal cannula, 44.5% (41/92) by Venturi mask, 31.5% (29/92) by CPAP, 2.2% (2/92) by BPAP, and 10.8% (10/92) by mechanical ventilation following intubation. On univariate analysis, patients with a body mass index >30, type II diabetes mellitus, and those presenting with dyspnoea, asthenia, SOFA score >/=2 points, PaO(2)/FiO(2) <300, temperature >38 degrees C, increased levels of lactate dehydrogenase (LDH), alanine aminotransferase, and C-reactive protein, and a d-dimer >1000 ng/mL at admission more frequently underwent NI/I-VS. Multivariate logistic regression analysis confirmed temperature >38 degrees C (odds ratio (OR) 21.2, 95% confidential interval (95% CI) 3.5-124.5, p = 0.001), LDH >250 U/l (OR 15.2, 95% CI 1.8-128.8, p = 0.012), and d-dimer >1000 ng/mL (OR 4.5, 95% CI 1.2-17.3, p = 0.027) as significantly associated with the requirement for NI/I-VS. A non-significant trend (p = 0.051) was described for PaO(2)/FiO(2) <300. CONCLUSIONS: Temperature >38 degrees C, LDH > 250 U/l, and d-dimer >1000 ng/mL were found to be independent risk factors for NI/I-VS in COVID-19 patients. In order to quickly identify patients likely at risk of developing a critical illness, inflammatory markers should be assessed upon hospital admission.
  • |*Respiration, Artificial[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |COVID-19/*therapy[MESH]
  • |Cohort Studies[MESH]
  • |Critical Illness[MESH]
  • |Diabetes Mellitus, Type 2/complications[MESH]
  • |Female[MESH]
  • |Hospital Mortality[MESH]
  • |Hospitalization[MESH]
  • |Humans[MESH]
  • |Intensive Care Units[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pandemics[MESH]
  • |Retrospective Studies[MESH]
  • |Risk Factors[MESH]


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