Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9481
Peer-review started: June 22, 2021
First decision: July 5, 2021
Revised: July 28, 2021
Accepted: August 25, 2021
Article in press: August 25, 2021
Published online: November 6, 2021
Processing time: 129 Days and 4.1 Hours
The clinical efficacy of ventilator treatment in coronavirus disease 2019 (COVID-19) patients is varied. As such, it is necessary to study the influencing factors on the efficacy of mechanical ventilation in severe and critical COVID-19 patients.
Mechanical ventilation has been included in the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 8) as an important treatment for severe and critical COVID-19 patients. However, the influencing factors on the efficacy of mechanical ventilation in severe and critical COVID-19 patients are unclear and worth studying.
This study determined the influencing factors on the efficacy of mechanical ventilation in severe and critical COVID-19 patients.
A total of 27 severe and critical COVID-19 patients were enrolled in this study and treated with mechanical ventilation. According to the final treatment outcomes, the patients were divided into the “effective group” and “death group.” The clinical data of the two groups such as treatment process and final outcome were retrospectively analyzed.
The 27 severe and critical COVID-19 patients were 17 males (63.0%) and 10 females (37.0%). Their ages were 74.41 ± 11.73-years-old, and 19 patients (70.4%) were over 70-years-old. Of the patients over 70-years-old treated with mechanical ventilation, 14 died. A total of 17 patients died of basic disease, 16 of whom had more than two basic diseases. The basic diseases were hypertension, diabetes and cardiovascular and cerebrovascular diseases. There were significant differences in the degree of infection, cardiac and renal function, and blood glucose between the death group and effective group.
Age, blood glucose, cardiac and renal function, and inflammatory reaction were important indicators of poor prognosis for mechanical ventilation in severe and critical COVID-19 patients.
In this study, we found that age, blood glucose, cardiac and renal function, and inflammatory reaction are important indicators of poor prognosis for mechanical ventilation in severe and critical COVID-19 patients. The use of tocilizumab may be a double-edged sword which carries a certain risk in clinical usage.