{"title":"COVID-19 第一波期间与 28 天危重病发展相关的因素。","authors":"Uluhan Sili, Pınar Ay, Hüseyin Bilgin, Ahmet Topuzoğlu, Elif Tükenmez-Tigen, Buket Ertürk-Şengel, Dilek Yağçı-Çağlayık, Baran Balcan, Derya Kocakaya, Şehnaz Olgun-Yıldızeli, Fethi Gül, Beliz Bilgili, Rabia Can-Sarınoğlu, Ayşegül Karahasan-Yağcı, Lütfiye Mülazimoğlu-Durmuşoğlu, Emel Eryüksel, Zekaver Odabaşı, Haner Direskeneli, Sait Karakurt, Volkan Korten","doi":"10.36519/idcm.2023.206","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to define the predictors of critical illness development within 28 days postadmission during the first wave of the COVID-19 pandemic.</p><p><strong>Materials and methods: </strong>We conducted a prospective cohort study including 477 PCR-positive COVID-19 patients admitted to a tertiary care hospital in Istanbul from March 12 to May 12, 2020.</p><p><strong>Results: </strong>The most common presenting symptoms were cough, dyspnea, and fatigue. Critical illness developed in 45 (9.4%; 95% CI=7.0%-12.4%) patients. In the multivariable analysis, age (hazard ratio (HR)=1.05, <i>p</i><0.001), number of comorbidities (HR=1.33, <i>p</i>=0.02), procalcitonin ≥0.25 µg/L (HR=2.12, <i>p</i>=0.03) and lactate dehydrogenase (LDH) ≥350 U/L (HR=2.04, <i>p</i>=0.03) were independently associated with critical illness development. The World Health Organization (WHO) ordinal scale for clinical improvement on admission was the strongest predictor of critical illness (HR=4.15, <i>p</i><0.001). The patients hospitalized at the end of the study period had a much better prognosis compared to the patients hospitalized at the beginning (HR=0.14; <i>p</i>=0.02). The C-index of the model was 0.92.</p><p><strong>Conclusion: </strong>Age, comorbidity number, the WHO scale, LDH, and procalcitonin were independently associated with critical illness development. Mortality from COVID-19 seemed to be decreasing as the first wave of the pandemic advanced.</p><p><strong>Graphic abstract: </strong>Graphic Abstract.</p>","PeriodicalId":21962,"journal":{"name":"Stem Cells International","volume":"2016 1","pages":"94-105"},"PeriodicalIF":3.8000,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10985825/pdf/","citationCount":"0","resultStr":"{\"title\":\"Factors Associated with 28-day Critical Illness Development During the First Wave of COVID-19.\",\"authors\":\"Uluhan Sili, Pınar Ay, Hüseyin Bilgin, Ahmet Topuzoğlu, Elif Tükenmez-Tigen, Buket Ertürk-Şengel, Dilek Yağçı-Çağlayık, Baran Balcan, Derya Kocakaya, Şehnaz Olgun-Yıldızeli, Fethi Gül, Beliz Bilgili, Rabia Can-Sarınoğlu, Ayşegül Karahasan-Yağcı, Lütfiye Mülazimoğlu-Durmuşoğlu, Emel Eryüksel, Zekaver Odabaşı, Haner Direskeneli, Sait Karakurt, Volkan Korten\",\"doi\":\"10.36519/idcm.2023.206\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to define the predictors of critical illness development within 28 days postadmission during the first wave of the COVID-19 pandemic.</p><p><strong>Materials and methods: </strong>We conducted a prospective cohort study including 477 PCR-positive COVID-19 patients admitted to a tertiary care hospital in Istanbul from March 12 to May 12, 2020.</p><p><strong>Results: </strong>The most common presenting symptoms were cough, dyspnea, and fatigue. Critical illness developed in 45 (9.4%; 95% CI=7.0%-12.4%) patients. In the multivariable analysis, age (hazard ratio (HR)=1.05, <i>p</i><0.001), number of comorbidities (HR=1.33, <i>p</i>=0.02), procalcitonin ≥0.25 µg/L (HR=2.12, <i>p</i>=0.03) and lactate dehydrogenase (LDH) ≥350 U/L (HR=2.04, <i>p</i>=0.03) were independently associated with critical illness development. The World Health Organization (WHO) ordinal scale for clinical improvement on admission was the strongest predictor of critical illness (HR=4.15, <i>p</i><0.001). The patients hospitalized at the end of the study period had a much better prognosis compared to the patients hospitalized at the beginning (HR=0.14; <i>p</i>=0.02). The C-index of the model was 0.92.</p><p><strong>Conclusion: </strong>Age, comorbidity number, the WHO scale, LDH, and procalcitonin were independently associated with critical illness development. Mortality from COVID-19 seemed to be decreasing as the first wave of the pandemic advanced.</p><p><strong>Graphic abstract: </strong>Graphic Abstract.</p>\",\"PeriodicalId\":21962,\"journal\":{\"name\":\"Stem Cells International\",\"volume\":\"2016 1\",\"pages\":\"94-105\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2023-06-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10985825/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Stem Cells International\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.36519/idcm.2023.206\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/6/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"CELL & TISSUE ENGINEERING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Stem Cells International","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36519/idcm.2023.206","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/6/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CELL & TISSUE ENGINEERING","Score":null,"Total":0}
Factors Associated with 28-day Critical Illness Development During the First Wave of COVID-19.
Objective: This study aimed to define the predictors of critical illness development within 28 days postadmission during the first wave of the COVID-19 pandemic.
Materials and methods: We conducted a prospective cohort study including 477 PCR-positive COVID-19 patients admitted to a tertiary care hospital in Istanbul from March 12 to May 12, 2020.
Results: The most common presenting symptoms were cough, dyspnea, and fatigue. Critical illness developed in 45 (9.4%; 95% CI=7.0%-12.4%) patients. In the multivariable analysis, age (hazard ratio (HR)=1.05, p<0.001), number of comorbidities (HR=1.33, p=0.02), procalcitonin ≥0.25 µg/L (HR=2.12, p=0.03) and lactate dehydrogenase (LDH) ≥350 U/L (HR=2.04, p=0.03) were independently associated with critical illness development. The World Health Organization (WHO) ordinal scale for clinical improvement on admission was the strongest predictor of critical illness (HR=4.15, p<0.001). The patients hospitalized at the end of the study period had a much better prognosis compared to the patients hospitalized at the beginning (HR=0.14; p=0.02). The C-index of the model was 0.92.
Conclusion: Age, comorbidity number, the WHO scale, LDH, and procalcitonin were independently associated with critical illness development. Mortality from COVID-19 seemed to be decreasing as the first wave of the pandemic advanced.
期刊介绍：
Stem Cells International is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of stem cell biology and applications. The journal will consider basic, translational, and clinical research, including animal models and clinical trials.
Topics covered include, but are not limited to: embryonic stem cells; induced pluripotent stem cells; tissue-specific stem cells; stem cell differentiation; genetics and epigenetics; cancer stem cells; stem cell technologies; ethical, legal, and social issues.
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