CLINICAL, SUB-CLINICAL FEATURES AND RISK FACTORS OF DEATH IN PEOPLE WITH SEVERE COVID-19, TREATMENT AT HA DONG GENERAL HOSPITAL (2021-2022)

Trương Trọng Vương, Vũ Huy Bùi

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Abstract

Objective: To find out the clinical and sub-clinical characteristics and risk factors for death in people with severe covid -19. Method: we conducted a retrospective study on 412 people with severe covid -19, treated at Ha Dong General Hospital, period 2021 - 2022. Results: Male/female ratio = 1.07, the disease occured in all age groups, 73.79% were in the > 60 year old group, the proportion of people with underlying diseases was 70.1%, and 66.7% have not been vaccinated against Covid-19. Common clinical manifestations were cough (81.1%), fever (64.6%), chest pain (62.9%), especially circulatory disorders (abnormal heart rate and blood pressure, respectively 59.4% and 44%), consciousness (decreased/comatose 36.2%, restlessness/fatigue 9.7%), anuria/oliguria (32.5%). On sub-clinical: many indicators of disorders, such as hematology, biochemistry, blood coagulation, blood gases and damage on chest X-ray. Multivariable logistic regression analysis, the indicators with independent prognostic value for death were: white blood cells >10G/l (OR=2.6; p=<0.01); Platelets <150x103/mm3 (OR=2.4; p=0.01); Urea >7.5mmo/l (OR=2.7; p=<0.01); Creatinine >120µmol/l (OR=2.6; p=<0.01) and LDH >500ng/ml (OR=2.8; p=<0.01). Conclusion: Clinical manifestations in patients with severe Covid-19 disease are not specific, there is a need for early diagnosis solutions based on screening tests and application of prognostic indicators for appropriate treatment intervention and risk reduction. dead.

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References

1. WHO (2021). Living guidance for clinical management of COVID-19: Living guidance, 23 November 2021 – World Health Organization (WHO).
2. Bộ Y Tế (2023). Hướng dẫn chẩn đoán và điều trị COVID-19 (Ban hành kèm theo Quyết định số 2671 /QĐ-BYT ngày 26/06/2023 của Bộ trưởng Bộ Y tế).
3. Booth A, Reed AB, Ponzo S, et al (2021). Population risk factors for severe disease and mortality in COVID-19: A global systematic review and meta-analysis. PLOS ONE. 16(3):e0247461.
4. Zhou F, Yu T, Du R, et al (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 395(10229):1054-1062.
5. Wang J, Zheng X, Chen J (2021). Clinical progression and outcomes of 260 patients with severe COVID-19: an observational study. Scientific Reports. 11(1):3166.
6. Phạm Minh Tuấn, Tr. V. Giang, P. N. Thạch (2022). Đặc điểm lâm sàng, cận lâm sàng và các yếu tố tiên lượng tử vong bệnh nhân covid-19 mức độ nặng, nguy kịch. Tạp chí Y học Việt nam;518 (1):124-128.
7. Wang H SB, Li X, Wang Y, Yang Z. (2022). Clinical analysis of severe COVID-19 patients. Technol Health Care.30(S1):225-234. doi: 210.3233/THC-228021. PMID: 35124599; PMCID: PMC39028659.
8. Gao Y-d, Ding M, Dong X, et al (2021). Risk factors for severe and critically ill COVID-19 patients: A review. Allergy.76(2):428-455.
9. Hu J, Wang Y. (2021). The Clinical Characteristics and Risk Factors of Severe COVID-19. Gerontology. 67(3):255-266.
10. Nguyễn Kim Thư Ph. B. Hiền, D. Q. Bảo (2024). Một số yếu tố tiên lượng tử vong của bệnh nhân covid-19 nặng và nguy kịch tại bệnh viện Đống Đa. Tạp chí nghiên cứu y học. 175 (02):11-17.