COVID-19: COMPLICATIONS IN ICU

INTERCURRENCES AND COMPLICATIONS PRESENTED BY PATIENTS HOSPITALIZED FOR COVID-19 IN AN INTENSIVE CARE UNIT

Authors

DOI:

https://doi.org/10.53843/bms.v10i14.613

Keywords:

COVID-19, Intensive Care Units, DEATH

Abstract

Introduction: COVID-19, caused by SARS-CoV-2, was declared a pandemic by the WHO in March 2020. The disease causes various symptoms and complications, especially in patients with comorbidities. The objective of this study was to understand what were the main complications and complications presented by patients hospitalized for COVID-19 in the intensive care unit (ICU) who died. Methods: This is a descriptive, quantitative, documentary research. We used collection and analysis of medical records of patients over 18 years of age diagnosed with COVID-19 who were admitted to the intensive care unit of a municipal hospital in XXX between May 2020 and May 2021, totaling 176 patients. Results: The mean age of the patients was 65 years, and 103 (58.5%) were male and 73 (41.5%) were female. Among them, the most prevalent disease was hypertension, present in 112 (63.3%) patients, followed by obesity in 68 (38.6%) patients and diabetes mellitus in 54 (30.7%) patients. The study revealed that the main complications in the patients studied were sepsis (97.1%), associated infection (87.4%), refractory hypoxia (83.5%), renal failure (78.4%), and pulmonary embolism (59.1%). Discussion: Sepsis can be caused by bacteria or by SARS-COV-2 itself, generating an insufficient response from the circulatory system. The presence of asthma and chronic obstructive pulmonary disease caused faster death, and obese patients died younger when compared to non-obese patients. In addition, hypertensive patients had renal failure as the main complication. Conclusion: We conclude that these correlations were important in understanding what a patient who dies from COVID-19 usually presents.

Metrics

Metrics Loading ...

Author Biographies

Gabriella Giandotti Gomar, Faculdades Pequeno Príncipe

Acadêmica de Medicina

Chayane Karol Cavalheiro, Faculdades Pequeno Príncipe

Acadêmica de Medicina

Michelle Simão, Faculdades Pequeno Príncipe

Doutora. Professora de Medicina Intensiva

References

Lima DLF, Dias AA, Rabelo RS, Cruz ID, Costa SC, Nigri FMN, et al. COVID-19 no estado do Ceará, Brasil: comportamentos e crenças na chegada da pandemia. Cien Saude Colet [Internet]. 2020 May [cited 2022 May 11];25(5):1575–86. Available from: https://www.scielo.br/j/csc/a/BtsPz7tPKSDfhTRKMzFCYCR/abstract/?lang=pt DOI: https://doi.org/10.1590/SciELOPreprints.14

Organização Pan-Americana da Saúde. OPAS/OMS. Brasil, 2020. Available from: https://www.paho.org/pt/search/r?keys=oms+declara+emergencia+de+saude+publica+de+importancia+internacional+em+relacao+a+novo+coronavirus+Brasil

Sociedade Brasileira de Análises Clínicas. SBAC. COVID-19. Brasil, 2020. Available from: https://www.sbac.org.br/blog/2020/04/06/covid-19/

Ministério da Saúde. MS. Como se proteger?. Brasil, 2021. Available from: https://www.gov.br/saude/pt-br/coronavirus/como-se-proteger

Souza LC, Silva TO, Pinheiro ARS, Santos FS. SARS-CoV, MERS-CoV e SARS-CoV-2: uma revisão narrativa dos principais Coronavírus do século. Brazilian Journal of Health Review [Internet]. 2021 [cited 2022 May 11];4(1):1419–39. Available from: https://brazilianjournals.com/index.php/BJHR/article/view/23263 DOI: https://doi.org/10.34119/bjhrv4n1-120

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet [Internet]. 2020 Feb [cited 2022 May 11]; 395(10223):497–506. Available from: https://www.sciencedirect.com/science/article/pii/S0140673620301835?casa_token=ljUgrW0RqiEAAAAA:qY05d6uXt9N0ksVQUOwpKYG2UP_gbJqiUqmXin9HdYxUI1K9YZJyCSgW4eMFIHifoDRhNzjre2hI DOI: https://doi.org/10.1016/S0140-6736(20)30183-5

Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int. j. infect. dis. [Internet]. 2020 May [cited 2022 May 12];94:91–5. Available from: https://www.sciencedirect.com/science/article/pii/S1201971220301363 DOI: https://doi.org/10.1016/j.ijid.2020.03.017

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet [Internet]. 2020 Mar [cited 2022 May 11];395(10229):1054–62. Available from: https://www.sciencedirect.com/science/article/pii/S0140673620305663?casa_token=VKCo7KaJwQQAAAAA:UBAhGEn6PBrHwRXS570KFFuVu3CoS4A4BIe3hnNGIV34qAkf_on_whaamxJdgWEkrxl1OyPLfhVc DOI: https://doi.org/10.1016/S0140-6736(20)30566-3

Azevedo LC, Park M, Salluh JI, Rea-Neto A, Souza-Dantas VC, Varaschin P, et al. Clinical outcomes of patients requiring ventilatory support in Brazilian intensive care units: a multicenter, prospective, cohort study. Crit. care. [Internet]. 2013 Apr [cited 2022 May 12];17(2). Available from: https://ccforum.biomedcentral.com/articles/10.1186/cc12594 DOI: https://doi.org/10.1186/cc12594

Carvalho GCF, Elias LM, Carvalho TR. Você sabe o que é uma UTI e sua importância na covid-19?. Minas Gerais: Secretaria de Estado de Saúde., 2020 [cited 2022 May 11]. Available from: https://coronavirus.saude.mg.gov.br/blog/61-o-que-e-uma-uti

Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav. res. meth. [Internet]. 2009 Nov [cited 2022 May 12];41(4):1149–60. Available from: https://link.springer.com/article/10.3758/BRM.41.4.1149 DOI: https://doi.org/10.3758/BRM.41.4.1149

The jamovi project (2020). jamovi. (Version 1.6) [Computer Software]. Retrieved from https://www.jamovi.org.

R Core Team (2020). R: A Language and environment for statistical computing. (Version 4.0) [Computer software]. Retrieved from https://cran.r-project.org. (R packages retrieved from MRAN snapshot 2020-08-24).

Hussain A, Mahawar K, Xia Z, Yang W, EL-Hasani S. RETRACTED: Obesity and mortality of COVID-19. Meta-analysis. Obesity research & clinical practice [Internet]. 2020 Jul [cited 2022 May 11];14(4):295–300. Available from: https://pubmed.ncbi.nlm.nih.gov/32660813 DOI: https://doi.org/10.1016/j.orcp.2020.07.002

Hajjar LA, Costa IBS da S, Rizk SI, Biselli B, Gomes BR, Bittar CS, et al. Intensive care management of patients with COVID-19: a practical approach. Ann. intensive care. [Internet]. 2021 Feb 18 [cited 2022 May 11];11(1). Available from: https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-021-00820-w DOI: https://doi.org/10.1186/s13613-021-00820-w

Schiffrin EL, Flack JM, Ito S, Muntner P, Webb RC. Hypertension and COVID-19. Am. j. hypertens. [Internet]. 2020 Apr 6 [cited 2022 May 11];33(5):373–4. Available from: https://pubmed.ncbi.nlm.nih.gov/32251498/ DOI: https://doi.org/10.1093/ajh/hpaa057

Grillet F, Behr J, Calame P, Aubry S, Delabrousse E. Acute Pulmonary Embolism Associated with COVID-19 Pneumonia Detected with Pulmonary CT Angiography. Radiology [Internet]. 2020 Sep [cited 2022 May 12];296(3):E186–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233384/ DOI: https://doi.org/10.1148/radiol.2020201544

Poyiadji N, Cormier P, Patel PY, Hadied MO, Bhargava P, Khanna K, et al. Acute Pulmonary Embolism and COVID-19. Radiology [Internet]. 2020 Dec [cited 2022 May 12];297(3):E335–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706099/ DOI: https://doi.org/10.1148/radiol.2020201955

García-Pachón E, Zamora-Molina L, Soler-Sempere MJ, Baeza-Martínez C, Grau-Delgado J, Padilla-Navas I, et al. Asma y EPOC en pacientes hospitalizados por COVID-19. Arch. bronconeumol. [Internet]. 2020 Sep [cited 2022 May 11];56(9):604–6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261473/ DOI: https://doi.org/10.1016/j.arbres.2020.05.007

Barbosa ATF, Carneiro JA, Ramos GCF, Leite MT, Caldeira AP. Fatores associados à Doença Pulmonar Obstrutiva Crônica em idosos. Ciênc. Saúde Colet. [Internet]. 2017 Jan [cited 2022 May 11];22(1):63–73. Available from: https://www.scielo.br/j/csc/a/nnYTJzYKnkK49cPvvPTh8fn/?lang=pt DOI: https://doi.org/10.1590/1413-81232017221.13042016

Jezler S, Holanda MA, José A, Franca S. III Consenso Brasileiro de Ventilação Mecânica Ventilação mecânica na doença pulmonar obstrutiva crônica (DPOC) descompensada. J Bras Pneumol [Internet]. 2007;33(2). Available from: https://www.scielo.br/j/jbpneu/a/THjBycQMGbwpNTsnCvmJG7h/?format=pdf&lang=pt DOI: https://doi.org/10.1590/S1806-37132007000800006

Lucchetti G, Mario A, Neto B, Augusto S, Ramos C, De Fátima L, et al. Uso de uma escala de triagem para cuidados paliativos nos idosos de uma instituição de longa permanência.Geriatria & Gerontologia. 2009;3(3); 104-108. Available from: https://cdn.publisher.gn1.link/ggaging.com/pdf/v3n3a02.pdf

Marta, GN, Hanna SA, Silva JLF. Cuidados paliativos e ortotanásia. Diagn Tratamento. 2010;15(2):58–60. Available from: http://files.bvs.br/upload/S/1413-9979/2010/v15n2/a58-60.pdf

Tufan ZK, Kayaaslan B, Mer M. COVID-19 and Sepsis. Turk. J. Med. Sci. 2021 Dec 17 [cited 2022 May 11];51(SI-1):3301–11. Available from: https://pubmed.ncbi.nlm.nih.gov/34590796/ DOI: https://doi.org/10.3906/sag-2108-239

Grasselli G, Scaravilli V, Mangioni D, Scudeller L, Alagna L, Bartoletti M, et al. Hospital-Acquired Infections in Critically Ill Patients With COVID-19. Chest [Internet]. 2021 Aug [cited 2022 May 12];160(2):454–65. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8056844/

Carvalho CRR. Pneumonia associada à ventilação mecânica. J. bras. pneumol. [Internet]. 2006 Aug [cited 2022 May 11];32(4):xx–xxii. Available from: https://www.scielo.br/j/jbpneu/a/cFC68NqJP5zmhVdfM5m96WJ/?lang=pt DOI: https://doi.org/10.1590/S1806-37132006000400003

Patil M, Singh S, Henderson J, Krishnamurthy P. Mechanisms of COVID‐19‐induced cardiovascular disease: Is sepsis or exosome the missing link? J. cell. physiol. [Internet]. 2020 Oct 20 [cited 2022 May 11];236(5):3366–82. Available from: https://pubmed.ncbi.nlm.nih.gov/33078408/ DOI: https://doi.org/10.1002/jcp.30109

Gasmi A, Peana M, Pivina L, Srinath S, Benahmed AG, Semenova Y, et al. Interrelations between COVID-19 and other disorders. Clin. immunol. [Internet]. 2021 Mar [cited 2022 May 12];224:108651. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833539/ DOI: https://doi.org/10.1016/j.clim.2020.108651

Halpin DMG, Criner GJ, Papi A, Singh D, Anzueto A, Martinez FJ, et al. Global Initiative for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease. The 2020 GOLD Science Committee Report on COVID-19 and Chronic Obstructive Pulmonary Disease. Am. j. respir. crit. care med. [Internet]. 2021 Jan 1 [cited 2022 May 12];203(1):24–36. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781116/ DOI: https://doi.org/10.1164/rccm.202009-3533SO

Published

05.04.2025

How to Cite

1.
Giandotti Gomar G, Karol Cavalheiro C, Simão M. COVID-19: COMPLICATIONS IN ICU: INTERCURRENCES AND COMPLICATIONS PRESENTED BY PATIENTS HOSPITALIZED FOR COVID-19 IN AN INTENSIVE CARE UNIT. BMS [Internet]. 2025 Apr. 5 [cited 2025 Apr. 19];10(14). Available from: https://bms.ifmsabrazil.org/index.php/bms/article/view/613

Most read articles by the same author(s)