PREDICTORS OF DEATH IN PATIENTS WITH COVID-19ON ARTIFICIAL LUNG VENTILATION

Relevance: with the increasing incidence of COVID-19, it is clear that early detection of the risk of death in patients on artificial lung ventilation (ALV) can help to ensure proper treatment planning and optimize health resources.The aim of our study was to identify predictors of the risk of death in ICU patients with COVID-19 on mechanical ventilation.Material and methods: research design - retrospective, observational, multicenter. Inclusion criteria: clinical, laboratory, and radiological criteria for severe viral community-acquired pneumonia. Exclusion criteria: death in the first 12 hours of hospitalization. End points: need for mechanical ventilation and death. 168 patients met the inclusion criteria. The number of patients who were given ALV was 69 (41,1%), 47 (68,1%) of them died. Risk factors were determined by calculating the odds ratio with a 95% confidence interval. The discriminative ability of factors was evaluated using ROC analysis with the calculation of the area under the curve (AUC ROC).Results: the most significant risk factors for ALV in patients with COVID-19 were a large extent of changes in the lung parenchyma, a higher score on the SOFA scale (> 5 points) and blood D - dimers > 3000 ng/ml. The deceased patients were more likelyМедицинский вестник Башкортостана. Том 15, № 6 (90), 202087to be men and initially had statistically significantly higher scores on the SOFA scale, neutrophil-to-lymphocyte ratio, and blood interleukin 6 (IL-6) content >186 ng/ml. However, the discriminative ability of these risk factors was moderate (AUC ROC from 0.69 to 0.76) in deceased patients, there was almost no dynamics of changes in the P/F ratio, blood D-dimer content, and SOFA severity assessment in the first three days of intensive care.Conclusion: Predictors of the development of an unfavorable outcome of the disease with moderate discrimination in patients with severe COVID-19 who are on ALV are: an increased score on the SOFA scale, an increase in the neutrophil-lymphocyte ratio, high levels of D-dimers and IL-6 in the blood.

SARS-CoV-2 pneumonia, COVID-19, artificial lung ventilation, death, risk factors

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