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©The Author(s) 2021.
World J Crit Care Med. Sep 9, 2021; 10(5): 244-259
Published online Sep 9, 2021. doi: 10.5492/wjccm.v10.i5.244
Published online Sep 9, 2021. doi: 10.5492/wjccm.v10.i5.244
Table 1 Coronavirus disease 2019 patients admitted to intensive care unit characteristics of survivors and non-survivors, n (%)
Non-survivor (n = 167) | Survivor (n = 94) | P value | OR | 95%CI | |
Age | 71 (61, 82) | 61 (62, 78) | 0.011 | ||
Race (Caucasian) | 89 (75) | 40 (56) | 0.007 | 2.37 | 1.27-4.40 |
BMI | 29 (23, 34) | 28 (24, 32) | 0.49 | ||
Sex (male) | 75 (70) | 83 (53) | 0.01 | 0.49 | 0.29-0.84 |
Diabetes | 31 (29) | 53 (34) | 0.3 | 1.26 | 0.75-2.2 |
CHF | 13 (12) | 21 (14) | 0.7 | 1.1 | 0.66 – 2.4 |
CAD | 24 (29) | 41 (27) | 0.41 | 1.2 | 0.7-2.2 |
COPD | 38 (23) | 23 (30) | 0.75 | 0.9 | 0.5-1.6 |
CKD | 11 (10) | 21 (17) | 0.1 | 1.85 | 0.87-3.83 |
HTN | 54 (51) | 91 (59) | 0.16 | 1.4 | 0.86-2.3 |
AKI | 87 (52) | 30 (32) | 0.002 | 2.3 | 1.21-2.5 |
Mechanical ventilation | 134 (80) | 44 (47) | < 0.001 | 4.7 | 2.7-8.3 |
Hemodialysis | 29 (18) | 10 (11) | 0.13 | 1.8 | 0.3-3.9 |
Neutrophils × 109/L | 7.3 (4, 10) | 7.8 (5.1, 13) | 0.97 | ||
Lymphocytes | 0.7 (0.5, 1.2) | 0.9 (0.6, 1.6) | 0.011 | ||
Neutrophil/lymphocyte | 10 (6, 18) | 7.5 (4, 14) | 0.017 | ||
SCr (mg/dL) | 1.2 (0.9, 1.9) | 1.2 (0.8, 1.8) | 0.49 | ||
Plts (× 109 /L) | 230 (162, 310) | 236 (182, 302) | 0.27 | ||
Tbili (mg/dL) | 0.5 (0.4, 0.8) | 0.5 (0.4, 0.8) | 0.65 | ||
SOFA admit | 5 (3, 9) | 4 (2, 6) | 0.095 | ||
PaO2/FIO2 | 190 (76, 285) | 232 (123, 307) | 0.039 | ||
PaO2 | 68 (52, 116) | 66 (48-112) | 0.083 | ||
FIO2 | 1 (0.45, 1) | 1 (0.96, 1) | 0.12 |
Table 2 Pharmacologic and therapeutic interventions in coronavirus disease 2019 intensive care unit patients, n (%)
Non-survivor (n = 167) | Survivor (n = 94) | P value | OR | 95%CI | |
GC (all patients)1 | 99 (59) | 68 (72) | 0.035 | 0.55 | 0.32-0.96 |
Vasopressors | 124 (74) | 35 (37) | < 0.001 | 4.8 | 2.8-8.4 |
IV Ascorbic acid | 100 (59) | 54 (57) | 0.7 | 1.1 | 0.66-1.84 |
Hydroxychloroquine | 128 (78) | 69 (75) | 0.57 | 1.2 | 0.65-2.1 |
Azithromycin | 65 (40) | 25 (26) | 0.06 | 1.69 | 0.97-2.9 |
Heparin therapeutic dose | 80 (48) | 51 (54) | 0.32 | 0.77 | 0.46-1.3 |
Heparin prophylaxis dose | 58 (35) | 32 (34) | 0.91 | 1.03 | 0.6-1.75 |
Convalescent plasma | 44 (26) | 27 (29) | 0.68 | 0.88 | 0.5-1.56 |
Remdesivir | 6 (3) | 0 (0) | |||
Prone positioning | 52 (31) | 32 (35) | 0.91 | 1.03 | 0.6-1.75 |
Tocilizumab | 20 (12) | 8 (8.5) | 0.55 | 1.28 | 0.56-2.9 |
GC only | 44 (26) | 29 (30) | 0.47 | 0.8 | 0.48-1.4 |
GC + tocilizumab | 55 (32) | 39 (40) | 0.16 | 0.68 | 0.4-1.15 |
Table 3 Univariate Cox proportional hazards survival analysis of pharmacological and therapeutic interventions in coronavirus disease 2019 intensive care unit patients
B | SE | P value | HR | 95%CI | |
GC (all patients) | -0.84 | 0.16 | < 0.001 | 0.45 | 0.38-0.61 |
Vasopressors | 0.039 | 35 | 0.027 | 1.4 | 1.05-2.1 |
IV ascorbic acid | 0.1 | 0.15 | 0.49 | 1.1 | 0.91-1.5 |
Hydroxychloroquine | -0.58 | 0.36 | 0.1 | 0.56 | 0.27-1.14 |
Azithromycin | 0.25 | 28 | 0.39 | 1.3 | 0.72-2.3 |
Heparin therapeutic dose | 0.15 | 0.35 | 0.67 | 1.16 | 0.51-2.31 |
Heparin prophylaxis dose | -0.27 | 0.3 | 0.35 | 0.76 | 0.48-1.3 |
Convalescent plasma | 0.29 | 1 | 0.77 | 1.3 | 0.72-9.8 |
Remdesivir | 6 (3) | 0 | |||
Prone positioning | 0.36 | 0.52 | 0.44 | 1.43 | 0.51-1.4 |
Tocilizumab | -0.48 | 0.27 | 0.08 | 0.61 | 0.36-1.06 |
GC only | -0.75 | 0.21 | 0.001 | 0.47 | 0.18-0.41 |
GC + tocilizumab | -1.3 | 0.21 | <0.001 | 0.27 | 0.4-1.15 |
Table 4 Inflammatory markers in coronavirus disease 2019 survivors and non-survivors
Non-survivors (n = 167) | Survivors (n = 94) | P value | |
IL-6 day 1 (pg/mL) | 112 (70, 137) | 100 (70, 135) | 0.34 |
IL-6 day 2 | 415 (139, 476) | 350 (78, 423) | 0.016 |
D-dimer day 1 (ng/mL) | 1125 (647, 2434) | 991 (513, 2196) | 0.04 |
D-dimer day 2 | 849 (604, 1210) | 1140 (646, 2263) | 0.03 |
CRP day 1 (mg/L) | 117 (89, 159) | 113 (96, 149) | 0.9 |
CRP day 2 | 107 (81, 154) | 117 (88, 167) | 0.62 |
Ferritin day 1 (ng/mL) | 931 (593, 1367) | 960 (609, 1395) | 0.51 |
Ferritin day 2 | 822 (447, 1432) | 1053 (712, 2057) | 0.05 |
Table 5 Unadjusted Cox proportional hazards analysis of independent predictors of survival in intensive care unit patients with coronavirus disease 2019
B | SE | P value | HR | 95%CI | |
Age | 0.031 | 0.007 | < 0.001 | 1.032 | 1.02-1.05 |
Sex (male) | 0.39 | 0.2 | 0.046 | 1.48 | 1.008-2.2 |
Vasopressors | 0.485 | 0.2 | 0.016 | 1.62 | 1.095-2.4 |
GC administration (all patients)1 | -0.61 | 0.19 | 0.002 | 0.54 | 0.37-0.79 |
Table 6 Propensity score adjusted Cox proportional hazards analysis of independent predictors of survival in intensive care unit patients with coronavirus disease 2019
B | SE | P value | HR | 95%CI | |
Age | 0.03 | 0.007 | < 0.001 | 1.031 | 1.02-1.05 |
Sex (male) | 0.41 | 0.2 | 0.038 | 1.51 | 1.022-2.22 |
Vasopressors | 0.47 | 0.23 | 0.019 | 1.6 | 1.081-2.37 |
GC + Tocilizumab | -0.78 | 0.22 | 0.001 | 0.46 | 0.29-0.72 |
GC only | -0.44 | 0.22 | 0.048 | 0.65 | 0.42-0.99 |
Table 7 Propensity score adjusted (glucocorticoids as a time-adjusted covariate) Cox proportional hazards analysis of independent predictors of survival in intensive care unit patients with coronavirus disease 2019
B | SE | P value | HR | 95%CI | |
Time adjusted GC | 2.5 | 1.01 | 0.014 | 12.9 | 1.06-87.5 |
Age | 0.03 | 0.007 | < 0.001 | 1.03 | 1.01-1.04 |
Sex (male) | 0.4 | 0.2 | 0.05 | 1.5 | 1-2.17 |
Vasopressors | 0.51 | 0.2 | 0.01 | 1.66 | 1.12-2.4 |
GC (all patients)1 | -2.94 | 1.01 | 0.004 | 0.05 | 0.007-0.36 |
Table 8 Propensity score adjusted (glucocorticoids as a time adjusted covariate) Cox proportional hazards analysis of independent predictors of survival in intensive care unit patients with all treatment groups added into the model
B | SE | P value | HR | 95%CI | |
Time adjusted GC | 2.5 | 1.01 | 0.015 | 12 | 1.62-85 |
Age | 0.03 | 0.007 | < 0.001 | 1.03 | 1.01-1.04 |
Sex (male) | 0.4 | 0.2 | 0.04 | 1.5 | 1.01-2.2 |
Vasopressors | 0.5 | 0.2 | 0.01 | 1.66 | 1.12-2.45 |
GC + tocilizumab | -3.07 | 1.02 | 0.003 | 0.046 | 0.006-0.46 |
GC (only) | -2.77 | 1.02 | 0.007 | 0.06 | 0.008-0.46 |
- Citation: Iglesias JI, Vassallo AV, Sullivan JB, Elbaga Y, Patel VV, Patel N, Ayad L, Benson P, Pittiglio M, Gobran E, Clark A, Khan W, Damalas K, Mohan R, Singh SP. Retrospective analysis of anti-inflammatory therapies during the first wave of COVID-19 at a community hospital. World J Crit Care Med 2021; 10(5): 244-259
- URL: https://www.wjgnet.com/2220-3141/full/v10/i5/244.htm
- DOI: https://dx.doi.org/10.5492/wjccm.v10.i5.244