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Clinical characteristics of critically ill patients with 2019 novel coronavirus (COVID-19): do we need a new triage system?

  • Mehmet Akif YAZAR1
  • Yasin TIRE1
  • Fatih YUCEL2
  • Hasan SENAY2
  • Ercan KURTIPEK3
  • Nevin SEKMENLI4
  • Guzide YAZAR4

1Department of Anesthesiology and Reanimation, University of Health Sciences, Konya Training and Research Hospital, 42040 Konya, Turkey

2Department of Intensive Care, University of Health Sciences, Konya Training and Research Hospital,42040 Konya, Turkey

3Department of Chest Diseases, University of Health Sciences, Konya Training and Research Hospital,42040 Konya, Turkey

4Department of Radiology, University of Health Sciences, Konya Training and Research Hospital,42040 Konya, Turkey

DOI: 10.22514/sv.2021.066 Vol.17,Issue 3,May 2021 pp.121-129

Submitted: 10 February 2021 Accepted: 09 March 2021

Published: 08 May 2021

*Corresponding Author(s): Mehmet Akif YAZAR E-mail: makifyazar@hotmail.com

Abstract

Background: This expanded study presents the characteristic features of patients with novel Coronavirus 2019 (COVID-19) in intensive care units (ICUs). On the other hand, it has revealed an issue of triage on admission to ICUs for patients with COVID-19.

Methods: The critically ill patients’ characteristics, laboratory findings, treatment and outcomes data were recorded. All chest computed tomography (c-CT) images were reviewed by two experienced radiologists in chest imaging. Collected data were compared between the confirmed and suspected COVID-19 cases. Moreover, some detected parameters were evaluated via c-CT findings among suspected COVID-19 cases.

Results: The study population included 105 patients hospitalized in ICUs. Twenty-seven patients (25.7%) were confirmed COVID-19 through real-time reverse-transcription polymerase-chain-reaction (RT-PCR) assay, and 78 patients (74.3%) were suspected COVID-19. There was a significant difference between the confirmed COVID-19 and suspected COVID-19 patients in terms of PaO2/FiO2 ratio, APACHE II scoring system, the number of comorbidities. Interestingly, in suspected cases, mean PaO2/FiO2 ratio, APACHE II score, and the number of comorbidities were significantly higher in patients with typical c-CT findings for COVID-19 (P = 0.038, P = 0.034 and P = 0.020, respectively). Considering all three parameters, 33.3% of cases with typical CT findings could be reconsidered as highly probable COVID-19 infections. Moreover, 16.7% of the cases with atypical CT findings could be excluded and the unnecessary burden on ICUs could be reduced.

Conclusion: In many contagious diseases such as COVID-19, for a new triage system, specific characteristics, selected general physiological findings, and typical laboratory parameters may be standardized in addition to RT-PCR testing and c-CT examination.


Keywords

Coronavirus; COVID-19; SARS CoV-2; Intensive care unit; Critical illness; Triage


Cite and Share

Mehmet Akif YAZAR,Yasin TIRE,Fatih YUCEL,Hasan SENAY,Ercan KURTIPEK,Nevin SEKMENLI,Guzide YAZAR. Clinical characteristics of critically ill patients with 2019 novel coronavirus (COVID-19): do we need a new triage system?. Signa Vitae. 2021. 17(3);121-129.

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