Triage and management of probable Covid-19 patients in the intensive care unit during the pandemic period

Main Article Content

Fatma Irem Yesiler
Emre Kandemir
Nursultan Akmatov
Tunay Kandemir
Tugba Yanik Yalcin
Helin Sahinturk
Ender Gedik
Pinar Zeyneloglu

Abstract

Aim: Republic of Turkey Ministry of Health dedicated our hospital as a transplant center during the pandemic period. We admitted probable Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infection (COVID-19) cases and intensive care unit (ICU) patients from other centers, while confirmed COVID-19 cases were transferred to dedicated pandemic hospitals. The aim of this study was to determine the demographic parameters, clinical courses and outcomes of probable COVID-19 patients and to compare survivors with non-survivors admitted to our ICU.
Materials and Methods: After Ethics Committee approval, 93 patients admitted to our ICU between March 23 and May 13 were analyzed retrospectively.
Results: Mean age was 68.5y (60.2% male). Dyspnea (67.7%) was the most common symptom and hypertension (68.6%) was the most common comorbidity. None of PCR tests for SARS-CoV-2 were positive. Bilateral ground-glass (25.8%) and consolidation (14%) were the most common signs at chest computed tomography. Mean Acute Physiology and Chronic Health Evaluation System (APACHE II) score was 20.2 at ICU admission. Fifty-seven patients (61.3%) had pneumonia findings in lung X-ray or computerized tomography (CT). Thirty-four patients (36.6%) received low flow oxygen, six (9.7%) had high flow nasal oxygen and 27 (29%) had invasive mechanical ventilation. Forty patients (43%) had vasopressor therapy and 24 (25.8%) patients had renal replacement therapy due to acute kidney injury. Laboratory data including D-dimer, C-reactive protein, ferritin, creatinine kinase and procalcitonin were significantly higher in non-survivors when compared to survivors. The overall ICU mortality rate was 44.1%.
Conclusions: A triage protocol of Turkish Study of Scientific Board based on clinical, laboratory and radiological findings for probable COVID-19 patients was applied in our center during the pandemic period. So, we ensured the effective usage of scarce ICU resources. The mortality rate of probable COVID-19 patients admitted to our ICU was found to be higher than the predicted mortality rate according to their APACHE-II score.

Downloads

Download data is not yet available.

Article Details

How to Cite
Yesiler, F. I., Kandemir, E., Akmatov, N., Kandemir, T., Yalcin, T. Y., Sahinturk, H., Gedik, E., & Zeyneloglu, P. (2021). Triage and management of probable Covid-19 patients in the intensive care unit during the pandemic period. Annals of Medical Research, 28(9), 1690–1698. Retrieved from https://annalsmedres.org/index.php/aomr/article/view/3909
Section
Original Articles

Most read articles by the same author(s)