Decompensated chronic diseases and clinical outcomes in patients with severe and critical COVID-19
Keywords:
chronic disease, chronic kidney disease, COVID-19, diabetes mellitus, hypertension, inflammation, mortality, SARS-CoV-2Abstract
Introduction: Prevalence of chronic diseases is high in patients with severe or critical COVID-19 and is associated with increased mortality.
Objective: To evaluate the relationship between decompensated chronic diseases and clinical outcomes in severe and critically ill COVID-19 patients.
Methods: A prospective cohort study of 32 severe and critically ill COVID-19 patients with > 24 hours’ length of intensive care unit stay in the Ambrosio Grillo Hospital from Santiago de Cuba between January and February 2021. Decompensated chronic diseases within 24 hours after intensive care unit admission were explored. Primary outcome variable was the mortality.
Results: The mean age of patients was 72.2 years (standard deviation 12.4 years) and 56.3% of them were males. Severe and critically ill patients were 40.6% and 59.4%, respectively. The mean SOFA score was 5.1 (standard deviation 3.5 points), 59.4% of patients had > 50% involvement in chest x-ray, and 56.2% required noninvasive ventilation and 34.4% invasive ventilatory support. Decompensated chronic diseases were found in 19 patients (59.4%); decompensated diabetes mellitus (13 cases; 40.6%), decompensated hypertension (10 cases; 31.3%) and acuted chronic kidney disease (9 cases; 28.1%) were the most common. Decompensated chronic diseases were associated with higher mortality (13.3% vs. 70.0%; p=0.021) and worsen COVID-19 (30.8% vs. 78.9%; p=0.018).
Conclusions: Decompensated chronic diseases are common disorders in severe and critically ill COVID-19 patients and are related to worse clinical outcomes.
