Outcome of percutaneous drainage for septic complications coexisted with COVID-19

Table 1 Patients’ demographics, comorbidities and outcome

	Cause of sepsis	Procedures	Age (yr)	Sex	Presentation	Co-morbidities	Ventilator	Tracheostomy	Outcome
Patient 1	Acute cholecystitis	Cholecystostomy	72	Male	Fever	IHD. AKI	40 d before drain	20 d before drain	Died 8 d post drain
Patient 2	Cholangitis and cholecystitis	Cholecystostomy	61	Male	Fever	Jaundice. AKI (on dialysis)	1 d before drain	12 d post drain	Died 16 d post drain
Patient 3	Acute cholecystitis	Cholecystostomy	55	Male	Abdominal pain	DM	No	No	Discharged 4 d post drain.
Patient 4	Post-operative biliary leakage resection of hemangioma	U/S guided drain	48	Female	Fever	DM. Septic shock	10 d post drain	No	Died 12 d post drain
Patient 5	Post-operative biliary leakage after liver resection for transplant	U/S guided drain	30	Male	Fever	No	No	No	Discharged 18 d post drain
Patient 6	Acute pancreatitis	CT-guided drain and EUS cystogastrostomy	43	Male	Abdominal pain	HTN. Hyperlipidemia	27 d post drain	No	Died 28 d post drain
Patient 7	Acute pancreatitis	U/S guided drain	41	Male	Abdominal pain	GB stones. Biliary obst. AKI	No	No	Discharged 10 d post drain
Patient 8	Recurrent hepatic abscess after surgical evacuation	U/S guided drain (2 tubes)	63	Male	Abdominal pain	DM. AKI	1 d before drain	1 d before drain	Died 19 d post drain
Patient 9	Right ilio-psoas and perivetebral abscesses	CT-guided drain then tube upsizing	60	Male	Abdominal pain	HTN. DM, AKI	3 d before drain	7 d post drain	Died 13 d post drain
Patient 10	Left lumbar region abscess and unhealthy sigmoid colon	CT-guided drainage. Sigmoid resection	31	Male	Abdominal pain and distension	Crohn’s disease. Achalasia. GJ. Esophageal dilatation	No	No	Clinical failure after 18 d followed by another tube insertion and sigmoid resection. Discharged 48 d
Patient 11	Right pyelonephritis	Rt PCN	30	Male	Abdominal pain	Right hemicolectomy	No	No	Discharged 9 d post drain. Recurrence after 39 d and managed by tube exchange

U/S: Ultrasonography; EUS: Endoscopic ultrasound; PCN: Percutaneous nephrostomy; IHD: Ischemic heart disease; AKI: Acute kidney injury; DM: Diabetes mellitus; HTN: Hypertension; GB: Gall bladder; GJ: Gastrojejunostomy.

Table 2 Data of drainage procedure, drained fluid, and chest imaging

	IR procedure	Drain	Guide	Puncture	Drained fluid	Culture		Chest imaging	COVID-19 severity	Lesion distribution	Time between PCR test and drainage
						Drain	Peripheral blood
Patient 1	Cholecystostomy	1 (8 Fr)	U/S	18G needle	Dark green	-ve	MDR (Klebsiella)	X-ray	Severe	Bilateral consolidation	48 d
Patient 2	Cholecystostomy	1 (8 Fr)	U/S	18G needle	Dark green	E.coli and Klebsiella pneumoniae	-ve	CT	Mild	Bilateral basal GGO with minimal effusion	3 d
Patient 3	Cholecystostomy	1 (8 Fr)	U/S	18G needle	Pus	P. aeruginoa. MRSA. E.coli	-ve	X-ray	Normal	Normal	5 d
Patient 4	Percutaneous drainage	1 (10 Fr)	U/S	18G needle	Infected bile	E.coli	-ve	CT	Sever	Bilateral consolidation with mild effusion	8 d
Patient 5	Percutaneous drainage	1 (8 Fr)	U/S	18G needle	Sero-sanginous	-ve	-ve	CT	Mild	Mild right pleural effusion	3 d
Patient 6	Percutaneous drainage	1 (10 Fr)	CT	21G needle	Brownish	E.coli and Klebsiella pneumoniae	-ve	CT	Mild	Left minimal effusion and basal GGO	17 d
Patient 7	Percutaneous drainage	1 (8 Fr)	CT	18G needle	Brownish	E.coli	-ve	CT	Mild	Bilateral basal GGO	2 d
Patient 8	Percutaneous drainage	2 (8 Fr)	U/S	18G needle	Clotted blood	-ve	-ve	X-ray	Normal	Mild right side pleural effusion	9 d
Patient 9	Percutaneous drainage	1 (10 Fr). 1 (8 Fr)	CT and US	21G needle	Pus	MRSA and staph aureus	-ve	CT	Severe	Bilateral GGO and consolidations	15 d
Patient 10	Percutaneous drainage	2 (8 Fr)	CT	21G needle	Pus	E.coli and Ent. Foecalis	NA	CT	Mild	Right side GGO	0 d
Patient 11	Right PCN	2 (8 Fr)	U/S and fluoro	21G needle	Pus	Klebsiella pneumoniae	-ve	X-ray	Normal	Normal	12 d

CT: Computed tomography; U/S: Ultrasonography; GGO: Ground-glass opacity; NA: Not available.

Table 3 Median (inter-quartile range) for laboratory findings before drainage, 1 d and 7 d after drainage

	Pre drain	D1	D7	P value
WBCs × 109/L	15.4 (12.50-17.40)	18.8 (10.6-22.1)	12.1 (10.3-21.8)	0.656
Neutrophil × 109/L	82.8 (72.3-91.8)	86.6 (70.4-94.2)	70.9 (60.9-92.3)	0.091
Lymphocyte × 109/L	6.8 (3.7-9.9)	7.10 (2.8-11.2)	10.9 (2.9-19.2)	0.032a
CRP (mg/L)	182.0 (91.0-368.0)	166.0 (32.0-80.0)	133.0 (26.0-170.0)	0.061
Creatinine (μmol/L)	122.0 (70.0-353.0)	109.0 (54.0-426.0)	97.0 (56.0-364.0)	0.789
Urea (mmol/L)	9.2 (5.8-19.7)	8.6 (3.6-22.4)	9.1 (2.8-28.2)	0.574
Bilirubin (μmol/L)	19.1 (15.0-28.4)	14.4 (29.9-12.4)	15.5 (12.5-21.8)	0.247
D-Dimer (ng/mL)	1441.0 (620.0-3340.0)	1363.0 (460.0-2780.0)	1413.0 (380.0-3560.0)	0.373
Procalcitonin (ng/mL)	1.5 (1.1-3.0)	1.87 (0.85-3.56)	1.5800 (0.31-3.11)	0.398
LDH (IU/L)	359.0 (194.0-750.0)	397.0 (155.0-768.0)	438.0 (144.0-798.0)	0.929

^aP < 0.05.

CRP: C-reactive protein; WBC: White blood cell; LDH: Lactate dehydrogenase.