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Risk factors of death in mechanically ventilated COVID-19 patients: a retrospective multi-center study

Salehi et al., Research Square, doi:10.21203/rs.3.rs-1362678/v1
Mar 2022  
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Mortality -14% Improvement Relative Risk HCQ for COVID-19  Salehi et al.  ICU PATIENTS Is very late treatment with HCQ beneficial for COVID-19? Retrospective 125 patients in Iran (April - September 2021) No significant difference in mortality c19hcq.org Salehi et al., Research Square, March 2022 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19hcq.org
Retrospective 125 mechanically ventilated ICU patients in Iran, showing no significant difference with HCQ treatment in unadjusted results.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
Study covers remdesivir, HCQ, and vitamin C.
risk of death, 14.5% higher, RR 1.14, p = 0.44, treatment 53 of 86 (61.6%), control 21 of 39 (53.8%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Salehi et al., 11 Mar 2022, retrospective, Iran, preprint, mean age 62.0, 11 authors, study period April 2021 - September 2021.
This PaperHCQAll
Risk factors of death in mechanically ventilated COVID-19 patients: a retrospective multi- center study
Mohammadreza Salehi, Mohammad-Taghi Beig Mohammadi, Seyed Hamidreza Abtahi, Samrand-Fattah Ghazi, Abolfazl Sobati, Rama Bozorgmehr, Seyed Ali Dehghan Manshadi, Saeed Reza Jamali Siahkali, Mostafa Mohammadi, Banafsheh Moradmand Badie, Ensiyeh Rahimi
doi:10.21203/rs.3.rs-1362678/v1
Introduction: Despite the improvement in COVID-19 therapeutic management the mortality of mechanically ventilated COVID-19 patients remains high. In this study, we determined risk factors of mortality in these cases. Methods: This retrospective study examined clinical and paraclinical data of COVID-19 patients mechanically ventilated at the time of hospitalization to ICU admission until death or discharge from hospital between April and September in 2021 in three COVID-19 referral hospitals. Results: One hundred twenty-ve patients (60% male, mean age 62 ± 15.18, range 17 to 97 years old) were recruited to this study. 51(40%) survived and 74 (60%) didn't survive. At the time of hospital admission, the vital signs were not signi cantly different between the survivors and non-survivors groups, also diarrhea was not reported in non-survivors, but reported in 9.5% of survivors (P = 0.02). The mean age of 74 non-survivors was higher than 51 survivors (65.1 ± 14.17 vs 56.9 ± 15.41, P = 0.003). The intubation time since the patients were admitted to hospitals was not signi cantly different between the two groups (3.38 ± 2.88 days vs 4.16 ± 3.42 days, P = 0.34). The mean LDH and D-dimer at the time of ICU admission were signi cantly higher in the non-survivors group (863 ± 449 vs 613 ± 326, P = 0.01; 4081 ± 3342 vs 542 ± 634, P = 0.009; respectively). However, the mean CRP was not signi cantly different between the two groups (76 ± 66.4, 54 ± 84.3; P = 0.1). Mean APACHE-II score was higher in the non-survivors than the survivors (15 vs 13; P = 0.01). Use of remdesivir, interfrone beta-1a, and low dose corticosteroids were signi cantly higher in the survivors group (P = 0.009, P = 0.001, P = 0.000). Conclusion: Success of weaning and hospital discharge among mechanically ventilated COVID-19 patients are probably higher in younger patients with lower D-dimmer and LDH levels that received low dose corticosteroids during treatment.
The study is retrospective. It was not possible to use written consent. According to the Medical Ethics Committee, patients' information remains con dential. Patients agreed to receive routine treatment upon arrival at the hospital. Then they received the treatment they needed. Finally, they were analyzed based on the treatment received in different groups. Consent for publication: We the authors give our consent for the publication of identi able details within the text to be published in the Journal of Critical Care.
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' '<jats:bold>Methods</jats:bold>: This retrospective study examined clinical and paraclinical ' 'data of COVID-19 patients mechanically ventilated at the time of hospitalization to ICU ' 'admission until death or discharge from hospital between April and September in 2021 in three ' 'COVID-19 referral hospitals. <jats:bold>Results</jats:bold>: One hundred twenty-five ' 'patients (60% male, mean age 62\u2009±\u200915.18, range 17 to 97 years old) were recruited ' 'to this study. 51(40%) survived and 74 (60%) didn’t survive. At the time of hospital ' 'admission, the vital signs were not significantly different between the survivors and ' 'non-survivors groups, also diarrhea was not reported in non-survivors, but reported in 9.5% ' 'of survivors (P\u2009=\u20090.02). The mean age of 74 non-survivors was higher than 51 ' 'survivors (65.1\u2009±\u200914.17 vs 56.9\u2009±\u200915.41, P\u2009=\u20090.003). The ' 'intubation time since the patients were admitted to hospitals was not significantly different ' 'between the two groups (3.38\u2009±\u20092.88 days vs 4.16\u2009±\u20093.42 days, P\u2009' '=\u20090.34). The mean LDH and D-dimer at the time of ICU admission were significantly higher ' 'in the non-survivors group (863\u2009±\u2009449 vs 613\u2009±\u2009326, P\u2009=\u20090.01; ' '4081\u2009±\u20093342 vs 542\u2009±\u2009634, P\u2009=\u20090.009; respectively). However, ' 'the mean CRP was not significantly different between the two groups (76\u2009±\u200966.4, ' '54\u2009±\u200984.3; P\u2009=\u20090.1). Mean APACHE-II score was higher in the non-survivors ' 'than the survivors (15 vs 13; P\u2009=\u20090.01). Use of remdesivir, interfrone beta-1a, and ' 'low dose corticosteroids were significantly higher in the survivors group (P\u2009=\u2009' '0.009, P\u2009=\u20090.001, P\u2009=\u20090.000). <jats:bold>Conclusion</jats:bold>: Success ' 'of weaning and hospital discharge among mechanically ventilated COVID-19 patients are ' 'probably higher in younger patients with lower D-dimmer and LDH levels that received low dose ' 'corticosteroids during treatment.</jats:p>', 'DOI': '10.21203/rs.3.rs-1362678/v1', 'type': 'posted-content', 'created': {'date-parts': [[2022, 3, 11]], 'date-time': '2022-03-11T17:18:09Z', 'timestamp': 1647019089000}, 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': [ 'Risk factors of death in mechanically ventilated COVID-19 patients: a retrospective multi- ' 'center study'], 'prefix': '10.21203', 'author': [ { 'given': 'Mohammadreza', 'family': 'Salehi', 'sequence': 'first', 'affiliation': [ { 'name': 'Department of Infectious Disease, Imam Khomeini Hospital ' 'complex, Tehran University of Medical Sciences'}]}, { 'given': 'Mohammad-Taghi Beig', 'family': 'Mohammadi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Anesthesiology & critical care, Imam Khomeini ' 'Hospital complex, Tehran University of Medical Sciences'}]}, { 'given': 'Seyed Hamidreza', 'family': 'Abtahi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of pulmonary and critical care medicine, Thoracic ' 'Research Center, Imam Khomeini Hospital complex, Tehran ' 'University of Medical Sciences, Tehran. 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Late treatment
is less effective
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