Title The clinical characters and prognosis of COVID-19 patients with multiple organ dysfunction
Authors Cui, Jianghua
Yuan, Boyun
Li, Yan
Li, Zhu
Yuan, Yadong
Affiliation Peking Univ, Dept Intens Care Med, Shougang Hosp, Beijing, Peoples R China
Hebei Med Univ, Dept Resp & Crit Care Med, Hosp 2, Shijiazhuang 050051, Hebei, Peoples R China
Hebei Med Univ, Dept Resp & Crit Care Med, Hosp 1, Shijiazhuang, Hebei, Peoples R China
Keywords CORONAVIRUS
MECHANISMS
WUHAN
Issue Date 15-Oct-2021
Publisher MEDICINE
Abstract To depict the clinical characters and prognosis of coronavirus disease 2019 patients who developed multiple organ dysfunction syndrome (MODS). A cohort consisted of 526 patients, which including 109 patients complicated MODS, was retrospectively analyzed to examine the clinical characteristics and risk factors of MODS. Among the 526 novel coronavirus-infected pneumonia patients, 109 patients developed multiple organ failure, the incidence rate was 20.7%. Among all 109 patients with MODS, 81.7% were over 60 years old, and 63.3% were male. The most common symptoms were fever (79.8%), dyspnea (73.4%), and fatigue (55.0%). Compared with patients non-MODS patients, there were 70 cases of MODS patients with one or more underlying diseases (64.2% vs 41.0%, P < .001). Respiratory failure (92.7%), circulatory failure (52.0%), and liver function injury (30.9%) were the most common symptoms within the spectrum of MODS. Invasive ventilator, noninvasive ventilator, and high-flow respiratory support treatment for patients in MODS patients were higher than those in the non-MODS group (P < .001). The antiviral therapy and 2 or more antibacterial drug treatments in MODS patients were higher than those in the non-MODS group (P < .001). The median hospital stay of all patients was 16 days (interquartile range [IQR], 9-26), of which 20 days (IQR, 11.5-30.5) in the MODS patients, which was approximately 4 days longer than that of non-MODS patients. In addition, our data suggested that lymphocyte counts <1.0 * 109/L, Troponin T > 0.014 ng/mL and lower oxygenation index were risk factors for MODS. In the early stage of hospital admission, higher inflammatory indexes and lactic acid concentration were associated with increased risk of death. MODS often leads to poor prognosis in coronavirus disease 2019. Our data suggested the importance of early identification of MODS. We recommend close monitoring and timely supportive therapy for patients with high risks, stopping the disease progression before it was too late.
URI http://hdl.handle.net/20.500.11897/632774
ISSN 0025-7974
DOI 10.1097/MD.0000000000027400
Indexed SCI(E)
Appears in Collections: 首钢医院

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