Survival of a cohort of COVID-19 patients on mechanical ventilation in the ICU of a Level III hospital in Bogotá, Colombia

Abstract

Background & Objective: The COVID-19 mortality varies from country to country. The pandemic has enriched our knowledge about the pathogenesis of the viral diseases in the human race. We aimed to establish survival curves based on a population of patients with confirmed diagnosis of COVID-19 who received mechanical ventilation in ICU of our level-III hospital.

Methodology: It is an observational study with a prospective cohort. All patients with a positive RT-PCR test for SARS-CoV-2 after the nasopharyngeal swab and who needed mechanical ventilation were identified. Kaplan–Meier survival estimates were calculated until the follow-up date of September 26, 2020.

Results: We included 62 patients in the study. The bivariate analysis found that congestive heart failure, kidney injury, dysnatremia, acid-base disorders, delta CO₂, and lactate levels were associated with higher mortality. When performing backward-type Cox regression, it was observed that the CO₂ delta [Hazard Ratio (HR) = 14.78, 95% CI: 2.1-100.5, P = 0.00] and lactate levels (HR = 6.15, 95% CI: 1.1-34.2, P = 0.038), were associated with an increase in mortality, for the admission variables. And only dysnatremia (HR = 5.28, 95% CI: 1.8-15.3, P = 0.00) and acid-base disorders (HR = 12.04: 95% CI: 4.1-35.3, P = 0.00) for the follow-up variables.

Conclusions: Among the factors associated with increased mortality in COVID-19 patients on mechanical ventilation in the first 24 h, parameters related to tissue hypoperfusion were identified. For the variables associated with mortality at 14 days, dysnatremia and acid-base disorders were identified.

Abbreviations: ng - Nanogram; FiO₂ - Inspired Oxygen Fraction, PEEP - Positive End-Expiratory Pressure; PAFI - Index of PaO₂/FiO₂; Delta CO₂ - Venous-to-Arterial Carbon Dioxide Difference; SIC - Sepsis-Induced Coagulopathy; SOFA - Sequential Organ Failure Assessment; NEW2 - National Early Warning Score 2

Key words: COVID-19; Critical Care; Mortality; Pulmonary Ventilation; Respiratory Distress Syndrome, Adult

Citation: Ortiz G, Garay M, Lara A, Llinas E, Betancur J, Mahecha J, Gomez D, Celemín C, Maiguel J, Murillo M. Survival of a cohort of COVID-19 patients on mechanical ventilation in the ICU of a Level III hospital in Bogotá, Colombia. Anaesth. pain intensive care 2023;27(5):458−463; DOI: 10.35975/apic.v27i5.2295

Received: September 28, 2022; Reviewed: June 12, 2023; Accepted: June 12, 2023