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10.4187/respcare.08319

http://scihub22266oqcxt.onion/10.4187/respcare.08319
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33446510!ä!33446510

suck abstract from ncbi


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pmid33446510      Respir+Care 2021 ; 66 (6): 897-908
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  • Clinical Characteristics, Respiratory Mechanics, and Outcomes in Critically Ill Individuals With COVID-19 Infection in an Underserved Urban Population #MMPMID33446510
  • Chaudhary S; Benzaquen S; Woo JG; Rubinstein J; Matta A; Albano J; De Joy R 3rd; Lo KB; Patarroyo-Aponte G
  • Respir Care 2021[Jun]; 66 (6): 897-908 PMID33446510show ga
  • BACKGROUND: The COVID-19 outbreak in the United States has disproportionately affected Black individuals, but little is known about the factors that underlie this observation. Herein, we describe these associations with mortality in a largely minority underserved population. METHODS: This single-center retrospective observational study included all adult subjects with laboratory-confirmed SARS-Cov-2 treated in our ICU between March 15 and May 10, 2020. RESULTS: 128 critically ill adult subjects were included in the study (median age 68 y [interquartile range 61-76], 45% female, and 64% Black); 124 (97%) required intubation. Eighty (63%) subjects died during their in-patient stay, which did not differ by race/ethnicity. Compared with other racial/ethnic groups, Blacks had a greater proportion of women (52% vs 30%, P = .02) and subjects with hypertension (91% vs 78%, P = .035). Asthma (P = .03) was associated with lower in-patient death, primarily among Black subjects (P = .02). Among Black subjects, increased age (odds ratio 1.06 [95% CI 1.05-1.22] per year), positive fluid balance (odds ratio 1.06 [95% CI 1.01-1.11] per 100 mL), and treatment with tocilizumab (odds ratio 25.0 [95% CI 3.5-180]) were independently associated with in-patient death, while higher platelets (odds ratio 0.65 [95% CI 0.47-0.89] per 50 x 10(3)/mL) and treatment with intermediate dose anticoagulants (odds ratio 0.08 [95% CI 0.02-0.43]) were protective. Among other race/ethnic groups, higher total bilirubin (odds ratio 1.75 [95% CI 0.94-3.25] per 0.2 mg/dL) and higher maximum lactate (odds ratio 1.43 [95% CI 0.96-2.13] per mmol/L) were marginally associated with increased death, while tocilizumab treatment was marginally protective (odds ratio 0.24 [95% CI 0.05-1.25]). During first 72 h of ventilation, those who died had less increase in [Formula: see text] (P = .046) and less reduction in PEEP (P = .01) and [Formula: see text] requirement (P = .002); these patterns did not differ by race/ethnicity. CONCLUSIONS: Black and other race/ethnicity subjects had similar mortality rates due to COVID-19 but differed in factors that were associated with increased risk of death. In both groups, subjects who died were older, had a positive fluid balance, and less improvement in [Formula: see text], PEEP, and [Formula: see text] requirement on ventilation.
  • |*COVID-19[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Critical Illness[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Respiratory Mechanics[MESH]
  • |Retrospective Studies[MESH]
  • |SARS-CoV-2[MESH]
  • |United States/epidemiology[MESH]
  • |Urban Population[MESH]


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