Zeng J, Qi XX, Cai WW, Pan YP, Xie Y. Retrospective analysis of influencing factors on the efficacy of mechanical ventilation in severe and critical COVID-19 patients. World J Clin Cases 2021; 9(31): 9481-9490 [PMID: 34877282 DOI: 10.12998/wjcc.v9.i31.9481]
Corresponding Author of This Article
Jia Zeng, MBBS, Associate Chief Physician, Department of Aviation Disease, Naval Medical Center of PLA, No. 338 Huaihai West Road, Changning District, Shanghai 200052, China. yijiacheng455@163.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 6, 2021; 9(31): 9481-9490 Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9481
Retrospective analysis of influencing factors on the efficacy of mechanical ventilation in severe and critical COVID-19 patients
Jia Zeng, Xiao-Xia Qi, Wan-Wan Cai, Ya-Ping Pan, Yi Xie
Jia Zeng, Department of Aviation Disease, Naval Medical Center of PLA, Shanghai 200052, China
Jia Zeng, No. 1 Department of Infection, Optical Valley Campus of Hubei Maternal and Child Health Care Hospital, Wuhan 430073, Hubei Province, China
Xiao-Xia Qi, Department of Traditional Chinese Medicine, Naval Medical Center of PLA, Shanghai 200052, China
Wan-Wan Cai, Department of Naval Diving Medicine, Naval Medical Center of PLA, Shanghai 200052, China
Ya-Ping Pan, Traditional Chinese Medicine, Naval Medical Center of PLA, Shanghai 200052, China
Yi Xie, Department of Hepatobiliary Surgery, Naval Medical Center of PLA, Shanghai 200052, China
Author contributions: Zeng J and Qi XX contributed equally to this work; Zeng J and Qi XX designed the research; Zeng J, Jiang WW, and Pan YP collected and analyzed the clinical data; Zeng J, Qi XX, and Xie Y wrote the manuscript; Xie Y revised the manuscript.
Institutional review board statement: This study was reviewed and approved by the Optical Valley Campus of the Hubei Maternal and Child Health Care Hospital Institutional Review Board (Approval No. FYGG(L)-2020-020) and Naval Medical University Institutional Review Board (Approval No. LW20160040).
Informed consent statement: Patients were not required to give informed consent to this study because the analysis used anonymous clinical data that was obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: No additional data is available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jia Zeng, MBBS, Associate Chief Physician, Department of Aviation Disease, Naval Medical Center of PLA, No. 338 Huaihai West Road, Changning District, Shanghai 200052, China. yijiacheng455@163.com
Received: June 22, 2021 Peer-review started: June 22, 2021 First decision: July 5, 2021 Revised: July 28, 2021 Accepted: August 25, 2021 Article in press: August 25, 2021 Published online: November 6, 2021 Processing time: 129 Days and 4.1 Hours
ARTICLE HIGHLIGHTS
Research background
The clinical efficacy of ventilator treatment in coronavirus disease 2019 (COVID-19) patients is varied. As such, it is necessary to study the influencing factors on the efficacy of mechanical ventilation in severe and critical COVID-19 patients.
Research motivation
Mechanical ventilation has been included in the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 8) as an important treatment for severe and critical COVID-19 patients. However, the influencing factors on the efficacy of mechanical ventilation in severe and critical COVID-19 patients are unclear and worth studying.
Research objectives
This study determined the influencing factors on the efficacy of mechanical ventilation in severe and critical COVID-19 patients.
Research methods
A total of 27 severe and critical COVID-19 patients were enrolled in this study and treated with mechanical ventilation. According to the final treatment outcomes, the patients were divided into the “effective group” and “death group.” The clinical data of the two groups such as treatment process and final outcome were retrospectively analyzed.
Research results
The 27 severe and critical COVID-19 patients were 17 males (63.0%) and 10 females (37.0%). Their ages were 74.41 ± 11.73-years-old, and 19 patients (70.4%) were over 70-years-old. Of the patients over 70-years-old treated with mechanical ventilation, 14 died. A total of 17 patients died of basic disease, 16 of whom had more than two basic diseases. The basic diseases were hypertension, diabetes and cardiovascular and cerebrovascular diseases. There were significant differences in the degree of infection, cardiac and renal function, and blood glucose between the death group and effective group.
Research conclusions
Age, blood glucose, cardiac and renal function, and inflammatory reaction were important indicators of poor prognosis for mechanical ventilation in severe and critical COVID-19 patients.
Research perspectives
In this study, we found that age, blood glucose, cardiac and renal function, and inflammatory reaction are important indicators of poor prognosis for mechanical ventilation in severe and critical COVID-19 patients. The use of tocilizumab may be a double-edged sword which carries a certain risk in clinical usage.
