Clinical Microbiology and Antimicrobial Chemotherapy. 2023; 25(4):350-357
To analyze the characteristics of patients with severe COVID-19 and lethal outcome.
This retrospective pharmacoepidemiological study (March – April 2021) enrolled 172 patients with confirmed COVID-19 and death in the intensive care unit of City Clinical Hospital No. 24.
The mean age was 74.4 ± 7.4 years, patients over 65 years old – 81% (n = 139), over 75 years old – 44% (n = 75). Males – 66% (n = 113). All patients had a secondary bacterial infection. The predominant COVID-19 complications were respiratory failure (100%), pulmonary edema (96%), multiorgan failure (96%), and acute respiratory distress syndrome (92.4%). All patients had concomitant diseases (cardiovascular – 94.2%, gastrointestinal tract – 81.2%, endocrine – 72.0%). The mean Charlson Comorbidity Index was 7.4 points. The mean length of hospital stay was 12.4 ± 11.0 days (range: 1–36 days), the maximum number of deaths was observed on the 9th day. Analysis of laboratory parameters revealed a significant increase in ferritin, lactate dehydrogenase, and C-reactive protein levels, WBC, absolute lymphocyte count, as well as a decrease in RBC and platelet count at the last measurement before death. All patients received antibiotic therapy (carbapenems – 24%, fluoroquinolones and cephalosporins – 20% each). Antiviral therapy was performed in 62% (n = 106), predominantly with favipiravir (88%).
The population of patients with fatal outcome due to COVID-19 was characterized by older age, high Charlson comorbidity index, predominance of cardiovascular, GI tract and endocrine diseases, and high levels of laboratory acute-phase inflammation markers.