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Evaluation of patients with negative PCR tests after COVID-19 pneumonia in intermediate-level intensive care unit

Year 2023, Volume: 9 Issue: 2, 237 - 243, 04.03.2023
https://doi.org/10.18621/eurj.1181609

Abstract

Objectives: The need for an intensive care unit has increased during the pandemic of coronavirus disease (COVID-19). For this reason, intermediate-level intensive care units (IICUs) were established in hospitals worldwide. This study aims to evaluate the data of patients that hospitalized in IICU.

Methods: Patients under treatment for COVID-19 were followed up in IICU after the negative polymerized chain reaction test. A total of 52 patients were evaluated retrospectively between August 24, 2020 and March 1, 2021. The patients were divided into two groups according to discharge status from IICU (Group 1: exitus, Group 2: transferred to clinic, or discharged home). Demographic data, comorbidities, Acute Physiology and Chronic Health Evaluation II (APACHE II), Glasgow Coma Scale (GCS), treatments and procedures, and complications were recorded.


Results:
Seventeen (32.7%) of 52 patients who were followed up in IICU died. Thirty-five patients (67.3%) were transferred to the clinic or discharged home. The APACHE II scores at admission to IICU were higher in Group 1 (26.11 ± 5.86) than in Group 2 (23.43 ± 6.32) but not statistically significant. GCS was statistically significantly lower in Group 1 than in Group 2 (7.82 ± 2.42 and 10.25 ± 2.58, respectively, p = 0.002). Mechanical ventilation rate (82.3%) and the need for inotropic agents (76.5%) were higher in Group 1 (p = 0,034 and p < 0.001, respectively). Tracheostomy was applied to 5 of all patients, and percutaneous endoscopic gastrostomy was performed 4 of them.

Conclusions: We think that IICU created during the pandemic provides effective treatment for patients needing intensive care. We think IICU is beneficial in providing quick patient discharge in tertiary intensive care units.

Supporting Institution

Bursa Yüksek İhtisas Training and Research Hospital

Thanks

Thanks to intermediate level intensive care unit's multidiciplinary team for studying together and telling our hardwork with this trial during the pandemic.

References

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  • 6. Carpagnano GE, Migliore G, Grasso S, Procacci V, Resta E, Panza F, Resta O. More skilled clinical management of COVID-19 patients modified mortality in an intermediate respiratory intensive care unit in Italy. Respir Res 2021;22:16.
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  • 9. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. China Medical Treatment Expert Group for COVID-19. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J 2020;55:2000547.
  • 10. Akelma FK, Altınsoy S, Çatalca S, Çaparlar CÖ, Sayın MM, Ergil J. Retrospective analysis of trauma patients in the intensive care unit. Gazi Med J 2021;32: 515-21.
  • 11. Zhao X, Li Y, Ge Y, Shi Y, Lv P, Zhang J, et al. Evaluation of nutrition risk and its association with mortality risk in severely and critically ill COVID-19 patients. JPEN 2021;45:32-42.
  • 12. Barazzoni R, Bischoff S C, Breda J, Wickramasinghe K, Krznaric Z, Nitzan D, et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr 2020;39:1631-8.
  • 13. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
  • 14. McWilliams D, Weblin J, Hodson J, Veenith T, Whitehouse T, Snelson C. Rehabilitation levels in patients with COVID-19 admitted to intensive care requiring invasive ventilation. An observational study. Ann Am Thorac Soc 2021;18:122-9.
  • 15. Eggmann S, Kindler A, Perren A, Ott N, Johannes F, Vollenweider R, et al. Early physical therapist interventions for patients with COVID-19 in the acute care hospital: a case report series. Phys Ther 2021;101:pzaa194.
  • 16. Debeuf R, Swinnen E, Plattiau T, De Smedt A, De Waele E, Roggeman S, et al. The Effect of physical therapy on impairments in COVID-19 patients from intensive care to home rehabilitation: a rapid review. J Rehabil Med 2022;54:jrm00242.
  • 17. Rizvi MAR, Hanif H, Rasheed N, Simon NH. Effects of respiratory therapy and physical rehabilitation in a reduction of length of ICU stay among Covid-19 Patients – A narrative review; Int J Med Sci Health Res 2021;5:106-21.
  • 18. Turgut N, Ak A, Ak E, Yakar N, Yakar N, Yılmaz B, et al. [Incidence, prevention and treatment of pressure ulcers in intensive care patients]. J Turk Soc Intens Care 2017;15:72-6. [Article in Turkish]
  • 19. Gefen A, Ousey K. CoviD-19: pressure ulcers, pain and the cytokine storm. J Wound Care 2020;29:540-2.
  • 20. Trevellini C. Challenges faced with morbidity obese patients during COVID-19. The 2020 Virtual Meeting of the European Pressure Ulcer Advisory Panel (EPUAP). https://www.epuap.org/wp-content/uploads/2020/09/epuap2020-virtual-abstract-book.qxp_sestava-1.pdf(accessed October 2020)
  • 21. Amini M, Mansouri F, Vafaee K, Janbakhsh A, Mahdavikian S, Moradi Y, et al. Factors affecting the incidence and prevalence of pressure ulcers in COVID-19 patients admitted with a Braden scale below 14 in the intensive care unit: retrospective cohort study. Int Wound J. 2022;19:2039-54.
  • 22. Kıraner E, Kaya H. [Pressure injuries in patients hospitalized in intensive care with the diagnosis of COVID-19 and retrospective analysis of risk factors]. Yoğun Bakım Hemşireliği Dergisi 2021;25:139-51. [Article in Turkish]
  • 23. Demirel Kaya HS, Mammadov O, Dogan L, Sarıkaya ZT, Kısa Özdemir İ, Rasimoğlu S, et al. [Patients with COVID-19 pneumonia treated with the standard protocol: observational results of five intensive care units]. J Turk Soc Intens Care 2020;18:1-13. [Article in Turkish]
Year 2023, Volume: 9 Issue: 2, 237 - 243, 04.03.2023
https://doi.org/10.18621/eurj.1181609

Abstract

References

  • 1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727‐33.
  • 2. Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed 2020;19;91:157-60.
  • 3. Masa JF, Patout M, Scala R, Winck JC. Reorganizing the respiratory high dependency unit for pandemics. Expert Rev Respir Med 2021;15:1505-15.
  • 4. T.C. Sağlık Bakanlığı Bilimsel Danışma Kurulu, COVID-19 (SARS-CoV-2 Enfeksiyonu) Ağır pnömoni, ARDS, Sepsis ve septik şok yönetimi. T.C.Sağlık Bakanlığı, 27 Mayıs 2021, Ankara. https://covid19.saglik.gov.tr/Eklenti/40781/0/covid19rehberiagirpnomoniardssepsisveseptiksokyontemipdf.pdf. Accessed May 30, 2021.
  • 5. Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A, et al. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep 2021;11:16144.
  • 6. Carpagnano GE, Migliore G, Grasso S, Procacci V, Resta E, Panza F, Resta O. More skilled clinical management of COVID-19 patients modified mortality in an intermediate respiratory intensive care unit in Italy. Respir Res 2021;22:16.
  • 7. Matute-Villacís M, Moisés J, Embid C, Armas J, Fernández I, Medina M, et al. Role of respiratory intermediate care units during the SARS-CoV-2 pandemic. BMC Pulm Med 2021;21:228.
  • 8. Carrillo Hernandez-Rubio J, Sanchez-Carpintero Abad M, Yordi Leon A, Doblare Higuera G, Garcia Rodriguez L, Garcia Torrejon C, et al. Outcomes of an intermediate respiratory care unit in the COVID-19 pandemic. PLoS One 2020;15:e0243968.
  • 9. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. China Medical Treatment Expert Group for COVID-19. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J 2020;55:2000547.
  • 10. Akelma FK, Altınsoy S, Çatalca S, Çaparlar CÖ, Sayın MM, Ergil J. Retrospective analysis of trauma patients in the intensive care unit. Gazi Med J 2021;32: 515-21.
  • 11. Zhao X, Li Y, Ge Y, Shi Y, Lv P, Zhang J, et al. Evaluation of nutrition risk and its association with mortality risk in severely and critically ill COVID-19 patients. JPEN 2021;45:32-42.
  • 12. Barazzoni R, Bischoff S C, Breda J, Wickramasinghe K, Krznaric Z, Nitzan D, et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr 2020;39:1631-8.
  • 13. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
  • 14. McWilliams D, Weblin J, Hodson J, Veenith T, Whitehouse T, Snelson C. Rehabilitation levels in patients with COVID-19 admitted to intensive care requiring invasive ventilation. An observational study. Ann Am Thorac Soc 2021;18:122-9.
  • 15. Eggmann S, Kindler A, Perren A, Ott N, Johannes F, Vollenweider R, et al. Early physical therapist interventions for patients with COVID-19 in the acute care hospital: a case report series. Phys Ther 2021;101:pzaa194.
  • 16. Debeuf R, Swinnen E, Plattiau T, De Smedt A, De Waele E, Roggeman S, et al. The Effect of physical therapy on impairments in COVID-19 patients from intensive care to home rehabilitation: a rapid review. J Rehabil Med 2022;54:jrm00242.
  • 17. Rizvi MAR, Hanif H, Rasheed N, Simon NH. Effects of respiratory therapy and physical rehabilitation in a reduction of length of ICU stay among Covid-19 Patients – A narrative review; Int J Med Sci Health Res 2021;5:106-21.
  • 18. Turgut N, Ak A, Ak E, Yakar N, Yakar N, Yılmaz B, et al. [Incidence, prevention and treatment of pressure ulcers in intensive care patients]. J Turk Soc Intens Care 2017;15:72-6. [Article in Turkish]
  • 19. Gefen A, Ousey K. CoviD-19: pressure ulcers, pain and the cytokine storm. J Wound Care 2020;29:540-2.
  • 20. Trevellini C. Challenges faced with morbidity obese patients during COVID-19. The 2020 Virtual Meeting of the European Pressure Ulcer Advisory Panel (EPUAP). https://www.epuap.org/wp-content/uploads/2020/09/epuap2020-virtual-abstract-book.qxp_sestava-1.pdf(accessed October 2020)
  • 21. Amini M, Mansouri F, Vafaee K, Janbakhsh A, Mahdavikian S, Moradi Y, et al. Factors affecting the incidence and prevalence of pressure ulcers in COVID-19 patients admitted with a Braden scale below 14 in the intensive care unit: retrospective cohort study. Int Wound J. 2022;19:2039-54.
  • 22. Kıraner E, Kaya H. [Pressure injuries in patients hospitalized in intensive care with the diagnosis of COVID-19 and retrospective analysis of risk factors]. Yoğun Bakım Hemşireliği Dergisi 2021;25:139-51. [Article in Turkish]
  • 23. Demirel Kaya HS, Mammadov O, Dogan L, Sarıkaya ZT, Kısa Özdemir İ, Rasimoğlu S, et al. [Patients with COVID-19 pneumonia treated with the standard protocol: observational results of five intensive care units]. J Turk Soc Intens Care 2020;18:1-13. [Article in Turkish]
There are 23 citations in total.

Details

Primary Language English
Subjects Intensive Care
Journal Section Original Articles
Authors

Filiz Ata 0000-0003-2472-1681

Canan Yılmaz 0000-0002-6626-3626

Ümran Karaca 0000-0001-5922-2300

Buket Özyaprak 0000-0002-6327-4573

Ayşe Neslihan Balkaya 0000-0001-8031-6264

Cihan Sedat Aytünür 0000-0001-9342-6710

Tuğba Onur 0000-0002-5080-4555

Publication Date March 4, 2023
Submission Date September 29, 2022
Acceptance Date December 2, 2022
Published in Issue Year 2023 Volume: 9 Issue: 2

Cite

AMA Ata F, Yılmaz C, Karaca Ü, Özyaprak B, Balkaya AN, Aytünür CS, Onur T. Evaluation of patients with negative PCR tests after COVID-19 pneumonia in intermediate-level intensive care unit. Eur Res J. March 2023;9(2):237-243. doi:10.18621/eurj.1181609

e-ISSN: 2149-3189 


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