Impact of Acute Complications on The Course and Outcome of Severe COVID-19: a Clinical Analysis and Determination of Mortality Predictors
Aim. To establish the features of the clinical picture, the structure of acute complications and predictors of mortality in patients with a severe course of COVID-19. Materials and methods. 221 patients who were in the intensive care unit (ICU) of City Clinical Hospital No. 1 in Vinnytsia, Ukrain...
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Professional Edition Eastern Europe
2025-03-01
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| Series: | Український журнал серцево-судинної хірургії |
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| Online Access: | https://cvs.org.ua/index.php/ujcvs/article/view/715 |
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| author | Tetiana D. Danilevych Lesia V. Rasputina |
| author_facet | Tetiana D. Danilevych Lesia V. Rasputina |
| author_sort | Tetiana D. Danilevych |
| collection | DOAJ |
| description | Aim. To establish the features of the clinical picture, the structure of acute complications and predictors of mortality in patients with a severe course of COVID-19.
Materials and methods. 221 patients who were in the intensive care unit (ICU) of City Clinical Hospital No. 1 in Vinnytsia, Ukraine were examined in the period 2020-2023. Among them, 133 (60.2%) patients survived and 88 (39.8%) of patients died as a result of a severe course of COVID-19 (p = 0.02).
Results. The mortality rate of patients with a severe course of COVID-19 was 39.8%. Among patients classified as categories 6 and 7 by the WHO, the highest mortality was observed, (p<0.001). In the group of deceased patients, there were significantly more patients with hypertension (73 (83.0%) vs. 90 (67.7%), p=0.008), coronary heart disease (CHD) (83 (94.3%) vs. 91 (68.4%)), p = 0.0001), a combination of CAD and hypertension (72 (81.8%) vs. 79 (59.4%), p < 0.001). In addition, acute/chronic kidney diseases (18 (20.5%) vs. 13 (9.8%), p = 0.022) and cancer were more common (12 (13.6%) vs. 8 (6.0%)), p = 0.046).
Among the acute complications that occurred during the stay of patients in the ICU, the deceased patients experienced significantly higher rates of the following conditions: stroke (10 (11.4%) vs. 3 (2.3%), p = 0.006), acute heart failure (9 (10.2%) vs. 4 (3.0%), p = 0.038), pulmonary embolism (9 (10.2%) vs. 3 (2.3%), p = 0.014), infectious toxic shock (10 (11.4%) vs. 1 (0.8%), p = 0.001), acute respiratory distress syndrome (78 (88.6%) vs. 6 (4.5%), p < 0.0001), endstage of renal failure (62 (80.5%) vs. 82 (62.1%), p = 0.006). Additionally, among rhythm disturbances, atrial fibrillation was more prevalent in deceased patients and was associated with a lower survival rate (31 (35.2%) vs. 19 (14.3%), p = 0.0001).
Conclusions. The study demonstrated that clinical factors associated with mortality in patients with a severe course of COVID-19 include patient age and с omorbidity such as hypertension, CAD, heart failure and rhythm disorders. Tachyarrhythmias and bradyarrhythmias were more often observed in deceased patients, in particular, they had more frequent AF, which emphasizes its role as a predictor of poor prognosis in patients with COVID-19. |
| format | Article |
| id | doaj-art-dab2f0b4979944fb85bfef96b30a6e33 |
| institution | Kabale University |
| issn | 2664-5963 2664-5971 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Professional Edition Eastern Europe |
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| series | Український журнал серцево-судинної хірургії |
| spelling | doaj-art-dab2f0b4979944fb85bfef96b30a6e332025-08-20T03:40:47ZengProfessional Edition Eastern EuropeУкраїнський журнал серцево-судинної хірургії2664-59632664-59712025-03-01331103111715Impact of Acute Complications on The Course and Outcome of Severe COVID-19: a Clinical Analysis and Determination of Mortality PredictorsTetiana D. Danilevychhttps://orcid.org/0000-0001-7088-521XLesia V. Rasputinahttps://orcid.org/0000-0003-1230-4039Aim. To establish the features of the clinical picture, the structure of acute complications and predictors of mortality in patients with a severe course of COVID-19. Materials and methods. 221 patients who were in the intensive care unit (ICU) of City Clinical Hospital No. 1 in Vinnytsia, Ukraine were examined in the period 2020-2023. Among them, 133 (60.2%) patients survived and 88 (39.8%) of patients died as a result of a severe course of COVID-19 (p = 0.02). Results. The mortality rate of patients with a severe course of COVID-19 was 39.8%. Among patients classified as categories 6 and 7 by the WHO, the highest mortality was observed, (p<0.001). In the group of deceased patients, there were significantly more patients with hypertension (73 (83.0%) vs. 90 (67.7%), p=0.008), coronary heart disease (CHD) (83 (94.3%) vs. 91 (68.4%)), p = 0.0001), a combination of CAD and hypertension (72 (81.8%) vs. 79 (59.4%), p < 0.001). In addition, acute/chronic kidney diseases (18 (20.5%) vs. 13 (9.8%), p = 0.022) and cancer were more common (12 (13.6%) vs. 8 (6.0%)), p = 0.046). Among the acute complications that occurred during the stay of patients in the ICU, the deceased patients experienced significantly higher rates of the following conditions: stroke (10 (11.4%) vs. 3 (2.3%), p = 0.006), acute heart failure (9 (10.2%) vs. 4 (3.0%), p = 0.038), pulmonary embolism (9 (10.2%) vs. 3 (2.3%), p = 0.014), infectious toxic shock (10 (11.4%) vs. 1 (0.8%), p = 0.001), acute respiratory distress syndrome (78 (88.6%) vs. 6 (4.5%), p < 0.0001), endstage of renal failure (62 (80.5%) vs. 82 (62.1%), p = 0.006). Additionally, among rhythm disturbances, atrial fibrillation was more prevalent in deceased patients and was associated with a lower survival rate (31 (35.2%) vs. 19 (14.3%), p = 0.0001). Conclusions. The study demonstrated that clinical factors associated with mortality in patients with a severe course of COVID-19 include patient age and с omorbidity such as hypertension, CAD, heart failure and rhythm disorders. Tachyarrhythmias and bradyarrhythmias were more often observed in deceased patients, in particular, they had more frequent AF, which emphasizes its role as a predictor of poor prognosis in patients with COVID-19.https://cvs.org.ua/index.php/ujcvs/article/view/715covid-19coronavirus diseaserhythm disordersmortalityatrial fibrillationarrhythmiaacute respiratory distress syndromepeacute heart failure |
| spellingShingle | Tetiana D. Danilevych Lesia V. Rasputina Impact of Acute Complications on The Course and Outcome of Severe COVID-19: a Clinical Analysis and Determination of Mortality Predictors Український журнал серцево-судинної хірургії covid-19 coronavirus disease rhythm disorders mortality atrial fibrillation arrhythmia acute respiratory distress syndrome pe acute heart failure |
| title | Impact of Acute Complications on The Course and Outcome of Severe COVID-19: a Clinical Analysis and Determination of Mortality Predictors |
| title_full | Impact of Acute Complications on The Course and Outcome of Severe COVID-19: a Clinical Analysis and Determination of Mortality Predictors |
| title_fullStr | Impact of Acute Complications on The Course and Outcome of Severe COVID-19: a Clinical Analysis and Determination of Mortality Predictors |
| title_full_unstemmed | Impact of Acute Complications on The Course and Outcome of Severe COVID-19: a Clinical Analysis and Determination of Mortality Predictors |
| title_short | Impact of Acute Complications on The Course and Outcome of Severe COVID-19: a Clinical Analysis and Determination of Mortality Predictors |
| title_sort | impact of acute complications on the course and outcome of severe covid 19 a clinical analysis and determination of mortality predictors |
| topic | covid-19 coronavirus disease rhythm disorders mortality atrial fibrillation arrhythmia acute respiratory distress syndrome pe acute heart failure |
| url | https://cvs.org.ua/index.php/ujcvs/article/view/715 |
| work_keys_str_mv | AT tetianaddanilevych impactofacutecomplicationsonthecourseandoutcomeofseverecovid19aclinicalanalysisanddeterminationofmortalitypredictors AT lesiavrasputina impactofacutecomplicationsonthecourseandoutcomeofseverecovid19aclinicalanalysisanddeterminationofmortalitypredictors |