TY  - JOUR
TI  - Factors Associated with 28-day Critical Illness Development During the First Wave of COVID-19
AB  - Objective: This study aimed to define the predictors of critical illness development within 28 days postadmission during the first wave of the COVID-19 pandemic. Materials and Methods: We conducted a prospective cohort study including 477 PCR-positive COVID-19 patients admitted to a tertiary care hospital in Istanbul from March 12 to May 12, 2020. Results: The most common presenting symptoms were cough, dyspnea, and fatigue. Critical illness developed in 45 (9.4%; 95% CI=7.0%-12.4%) patients. In the multivariable analysis, age (hazard ratio (HR)=1.05, p <0.001), number of comorbidities (HR=1.33, p=0.02), procalcitonin ≥0.25 μg/L (HR=2.12, p=0.03) and lactate dehydrogenase (LDH) ≥350 U/L (HR=2.04, p=0.03) were independently associated with critical illness development. The World Health Organization (WHO) ordinal scale for clinical improvement on admission was the strongest predictor of critical illness (HR=4.15, p<0.001). The patients hospitalized at the end of the study period had a much better prognosis compared to the patients hospitalized at the beginning (HR=0.14; p=0.02). The C-index of the model was 0.92. Conclusion: Age, comorbidity number, the WHO scale, LDH, and procalcitonin were inde- pendently associated with critical illness development. Mortality from COVID-19 seemed to be decreasing as the first wave of the pandemic advanced.
AU  - Gul, Fethi
AU  - Bilgili, Beliz
AU  - Cinel, Ismail
AU  - Eryüksel, Semiha Emel
AU  - KARAKURT, SAİT
AU  - Bilgin, Huseyin
AU  - Tukenmez Tigen, Elif
AU  - OLGUN, Sehnaz
AU  - Topuzoğlu, Ahmet
AU  - ERTURK SENGEL, Buket
AU  - MULAZIMOGLU, LUTFIYE
AU  - karahasan, aysegul
AU  - Sili, Uluhan
AU  - AY, NADIYE PINAR
AU  - Yağcı Çağlayık, Dilek
AU  - Balcan, Baran
AU  - Kocakaya, Derya
AU  - Can Sarınoğlu, Rabia
AU  - odabasi, zekaver
AU  - Direskeneli, Haner
AU  - KORTEN, VOLKAN
DO  - 10.36519/idcm.2023.206
PY  - 2023
JO  - Infectious diseases and clinical microbiology (Online)
VL  - 5
IS  - 2
SN  - 2667-646X
SP  - 94
EP  - 105
DB  - TRDizin
UR  - http://search/yayin/detay/1183910
ER  -