Medicina Pulmonar e Respiratória

Identification of Risk Factors Predicting Mortality in Patients with Acute Respiratory Distress Syndrome Related to Severe COVID-19

Abstract

Alizamin Sadigov, Malahat Sultanova, Emil Gasimov, Gunel Sadigova, Sharaf Huseynova and Cavid Pashayev

Acute Respiratory Distress Syndrome (ARDS) is one of the common clinical manifestation of severe COVID-19 and it is also responsible for the high ventilators demand in worldwide. Our study aims to assess the risk factors predicting mortality in patients with ARDS developing as complication of severe COVID -19. We collected clinical data of 289 COVID- 19 related to ARDS patients from 4 hospitals in Baku city, Azerbaijan. The clinical characteristics of the survivors ARDS group and non-survivors ARDS group of COVID-19 patients were clinically, laboratory and radiographically compared.

Results indicated that the median age of non-survivors ARDS patients was 68.4 years old, which was significantly older than those with survivors ARDS by 9,9 years. Male and patients with BMI>30 were more likely to die from ARDS. The prevalence of consolidation (Consolidation\ground glass opacities ratio>1) in lung, secondary bacterial infection, mechanical ventilation and pack of use dexamethasone before intubation were common among non-survivors ARDS.

Carlson index was higher in non-survivors ARDS patients (p=0.001). Among laboratory values most important risk factors predicting death of patients with ARDS were: D-dimer (p=0.0001), creatinine (p<0.009), lymphocytes can’t <0.6 × 10⁹ (p ≤ 0.045), procalcitonin (p<0.01), and brain natriuretic peptide (p<0.0001). SOFA score at the time of admission was higher in non survivors ARDS patients (p<0.05). Partial pressure of oxygen to fraction of inspired oxygen (PaO₂/FiO₂) at the time of admission also was significantly lower compared to survivors ARDS patients (p<0.05) and arterial blood gas analysis values were significantly differ: partial pressure of carbon dioxide (PaCO₂) was markedly higher (p=0.023), PaO₂ was lower (p=0.026) and acidity of the blood pH was also lower (p=0.02).

We identified predictors of mortality in patients with ARDS related to severe COVID-19. These findings may be helpful for healthcare providers take appropriate measures and impact to clinical outcomes in patients with severe COVID-19 complicated with ARDS.