Retrospective analysis of influencing factors on the efficacy of mechanical ventilation in severe and critical COVID-19 patients

Table 1 Clinical data of patients

Clinical characters	n (%)	Death group, 17 cases, n (%)	Effective group, 10 cases, n (%)	P value
Gender
Male	17	11 (64.7)	6 (35.3)	0.310
Female	10	6 (60)	4 (40)
Age (yr)	74.41 ± 11.73	77.94 ± 10.49	68.4 ± 11.75	0.049a
< 60	6 (22.2)	2 (11.8)	4 (40)	0.10
60–69	2 (7.4)	1 (5.9)	1 (10)	0.48
70–79	7 (25.9)	4 (23.5)	3 (30)	0.32
> 80	12 (44.4)	10 (58.8)	2 (20)	0.049a
Underlying disease
Hypertension	15 (55.6)	8 (47)	7 (70)	0.17
Diabetes	10 (37)	8 (47)	2 (20)	0.13
Cardiopathy	9 (33.3)	5 (29.4)	4 (40)	0.28
Nervous system disease	10 (37)	7 (41.2)	3 (30)	0.28
Respiratory disease	8 (29.6)	4 (23.5)	4 (40)	0.23
Malignant tumor	6 (22.2)	4 (23.5)	2 (20)	0.36
Digestive system disease	2 (7.4)	1 (5.9)	1 (10)	0.48
Hematological disease	1 (3.7)	1 (5.9)	0 (0)	0.63
Chronic renal insufficiency	4 (14.8)	2 (11.8)	2 (20)	0.35
Rheumatoid arthritis	1 (3.7)	1 (5.9)	0 (0)	0.63
Decubitus	1 (3.7)	1 (5.9)	0 (0)	0.63
More than two diseases	23 (85.2)	16 (94.1)	7 (70)	0.12
Clustering onset	10 (37)	8 (47)	2 (20)	0.13
Admission classification
Severe	16 (59.3)	10 (58.8)	6 (60)	0.31
Critical	11 (40.7)	7 (41.2)	4 (40)
SpO2 at rest on admission (%)	85.0 ± 13.46	82.82 ± 16.47	88.7 ± 4.11	0.28
CT on admission
Multiple lesions in both lungs	21 (87.5)	13 (76.5)	8 (80)	0.36
Limited in single lung	6 (7.4)	4 (23.5)	2 (20)
Ventilation mode
Noninvasive ventilation	15 (55.6)	10 (58.8)	5 (50)	0.28
Invasive ventilation	21 (77.8)	13 (76.5)	8 (90)	0.36
ECMO	3 (11.1)	1 (5.9)	2 (20)	0.26
Prone position ventilation	7 (25.9)	4 (23.5)	3 (30)	0.32
Tocilizumab	14 (51.9)	9 (52.9)	5 (50)	0.31
Glucocorticoid	15 (55.6)	12 (70.6)	3 (30)	0.04a
Oxygenation index before ventilation	132.64 ± 59.3	122.31 ± 56.88	149.16 ± 62.32	0.270
Days of ventilator treatment	7.04 ± 6.65	4.76 ± 4.63	10.9 ± 7.95	0.011a
Complications
Bacterial pneumonia	24 (88.9)	14 (82.4)	10 (100)	0.23
Anemia	18 (66.7)	12 (70.6)	6 (60)	0.28
Pneumothorax	3 (11.1)	2 (11.8)	1 (10)	0.46
Pleural effusion	5 (18.5)	4 (23.5)	1 (10)	0.29
Arrhythmia	8 (29.6)	7 (41.2)	1 (10)	0.09
Myocardial ischemia	12 (44.4)	10 (58.8)	2 (20)	0.049a
Heart failure	10 (37)	9 (52.9)	1 (10)	0.03a
Hepatic dysfunction	8 (29.6)	5 (29.4)	3 (30)	0.33
Acute renal dysfunction	7 (25.9)	5 (29.4)	2 (20)	0.31
Gastrointestinal hemorrhage	3 (11.1)	3 (17.6)	0 (0)	0.23
Shock	17 (63)	16 (94.1)	1 (10)	0.004a
Abnormal blood glucose	19 (70.4)	13 (76.5)	6 (60)	0.23
Electrolyte disorder	10 (37)	6 (35.3)	4 (40)	0.31
Hemoptysis	1 (3.7)	0 (0)	1 (10)	0.37

^aP < 0.05.

CT: Computed tomography; ECMO: Extracorporeal membrane oxygenation.

Table 2 Related test results of patients before and after ventilation

Item	Death group, 17 cases			Effective group, 10 cases
	On admission	Before ventilation	Before death	On admission	Before ventilation	Before discharge
Lactic acid	2.44 ± 1.07	5.82 ± 6.27	17.41 ± 7.10b	2.00 ± 0.12	2.00 ± 0.12	2.00 ± 0.12
IL-6	347.53 ± 922.41a,b	125.76 ± 139.63a,b	12099.43 ± 19424.47a,b	2.36 ± 1.75	1.50 ± 1.22	1.00 ± 0.89
CRP	123.20 ± 94.63	151.02 ± 82.27	129.23 ± 86.94	6802.48 ± 9458.94a,b	854.56 ± 1322.69a,b	878.56 ± 1251.27a,b
Blood glucose	8.45 ± 4.37	10.97 ± 5.91	10.38 ± 5.83	12.72 ± 9.76	126.03 ± 146.14a,b	135.51 ± 158.42a,b
PLT	151.00 ± 83.35b	171.13 ± 103.79	96.27 ± 97.446	14.86 ± 13.02	70.27 ± 13.06	77.74 ± 15.31
D-Dimer	13.38 ± 30.23	17.18 ± 30.18	13.06 ± 17.51	4.21 ± 3.70	2.30 ± 1.64	49.5 ± 41.95
BNP	250.36 ± 349.23a,b	753.91 ± 1323.52a,b	1410.28 ± 1806.89a,b	1.0 ± 0.12	1.40 ± 0.52	1.90 ± 0.32
Cr	81.70 ± 39.82	78.75 ± 34.44	105.81 ± 55.53b	65.32 ± 41.76	49.94 ± 59.33	1.18 ± 2.65
Lymphocyte	1.04 ± 1.34	0.57 ± 0.45	0.55 ± 0.50	1.46 ± 2.09	1.45 ± 1.60	1.04 ± 1.09
Lymphocyte/granulocyte ratio (%)	16.58 ± 29.10	4.58 ± 3.87	7.15 ± 7.47	57.37 ± 42.08	273.06 ± 109.09a,b	79.4 ± 25.15b

^aP < 0.05 (in same group).

^bP < 0.05 (between two groups).