Mortality among young adults in intensive care unit diagnosed with SARS-CoV-2 infection.
Marina Melo Martin, José Edilson de Oliveira, Priscila Gama Silva and 5 others
PMID 42339928WHAT IT FOUND
In 105 young adults treated in ICU for confirmed COVID-19, 27.6% died.
Higher lactate and more vasopressor days were linked to death; organ dysfunction, sepsis, ventilation and unstable circulation also occurred more among deaths.
Key findings
01Death occurred in 27.6% of the 105 young adults admitted to the ICU with a diagnosis of COVID-19.
02The study identified higher lactate and vasopressor days as risk factors for ICU death: each one-unit increase in lactate was associated with a 6.1% higher chance of death, and each one-unit increase in vasopressor days with a 12% higher chance.
03Organ dysfunction, sepsis, mechanical ventilation, hemodynamic instability, vasopressor use, elevated CRP, lactate and lymphocyte values, and need for renal replacement therapy were associated with death.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used records from a single university hospital, so the results may not apply to other ICUs or populations. It included all eligible patients without a sample size calculation, and patients with incomplete records were excluded. Because it was retrospective and observational, it can show associations but cannot prove that any treatment or complication caused death. Treatments such as vasopressors, mechanical ventilation, heparin and corticosteroids were more common in patients who died, but this may reflect that sicker patients received these treatments rather than the treatments causing death. The small number of deaths limited how many variables could be adjusted at once, and the model was built by selecting variables that were significant.
The easy way to misread this
Do not read the significant associations with vasopressors, mechanical ventilation, heparin and corticosteroids as evidence that these treatments caused death; they were markers of severity in a retrospective single center study, and the study did not test any treatment.