Systolic Pulmonary Artery Pressure as Long-Term Mortality Predictor in Elderly Critically Ill with Severe COVID-19 Pneumonia.

IF 3.5 3区医学 Q2 VIROLOGY Viruses-Basel Pub Date : 2025-02-11 DOI:10.3390/v17020244

Marko Kurnik, Helena Božič, Matej Podbregar

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Abstract

Background: COVID-19 can cause acute pulmonary hypertension (PH), worsening outcomes in critically ill elderly patients. Point-of-care ultrasound (POCUS), assessing right ventricular hemodynamics, predicts short-term outcomes. This study examines the long-term impact of acute PH on mortality in elderly COVID-19 patients.

Methods: This retrospective long-term study analyzed data from patients over 70 years old with severe COVID-19 pneumonia admitted to a mixed 25-bed, level 3 intensive care unit (ICU). POCUS focused on systolic pulmonary artery pressure (sPAP) at admission. Mortality was evaluated 1000 days post-admission.

Results: The study included 130 patients, comprising 30 long-term survivors and 100 non-survivors, with a cumulative long-term mortality rate of 77%. Non-survivors had significantly higher sPAP values (39.1 ± 12.8 vs. 30.4 ± 9.2, p = 0.04), which were associated with long-term mortality in survival analysis.

Conclusion: Acute pulmonary hypertension (PH), reflected by elevated systolic pulmonary artery pressure (sPAP), is strongly associated with long-term mortality in elderly critically ill COVID-19 patients. Early assessment of sPAP via POCUS may help identify high-risk patients and guide management strategies to improve outcomes.

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收缩压与老年重症COVID-19肺炎的长期死亡率预测

背景：COVID-19可引起急性肺动脉高压（PH），恶化危重老年患者的预后。即时超声（POCUS），评估右心室血流动力学，预测短期预后。本研究探讨了急性PH对老年COVID-19患者死亡率的长期影响。方法：本回顾性长期研究分析了在25个床位的三级重症监护病房（ICU）住院的70岁以上重症COVID-19肺炎患者的数据。POCUS关注的是入院时的收缩期肺动脉压（sPAP）。入院后1000天评估死亡率。结果：研究纳入130例患者，包括30例长期幸存者和100例非幸存者，累积长期死亡率为77%。在生存分析中，非幸存者的sPAP值显著较高（39.1±12.8比30.4±9.2,p = 0.04），与长期死亡率相关。结论：急性肺动脉高压（Acute pulmonary hypertension， PH）与老年危重患者长期死亡率密切相关，其表现为肺动脉收缩压（sPAP）升高。通过POCUS对sPAP进行早期评估可能有助于识别高危患者并指导管理策略以改善预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Viruses-Basel VIROLOGY-

CiteScore

7.30

自引率

12.80%

发文量

2445

审稿时长

1 months

期刊介绍： Viruses (ISSN 1999-4915) is an open access journal which provides an advanced forum for studies of viruses. It publishes reviews, regular research papers, communications, conference reports and short notes. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced. We also encourage the publication of timely reviews and commentaries on topics of interest to the virology community and feature highlights from the virology literature in the ''News and Views'' section. Electronic files or software regarding the full details of the calculation and experimental procedure, if unable to be published in a normal way, can be deposited as supplementary material.