PDF(Pubmed)
Abstract：
From the first reports of SARS-CoV-2, at the end of 2019 to the present, the global mortality associated with COVID-19 has reached 6,952,522 deaths as reported by the World Health Organization (WHO). Early intubation and mechanical ventilation can increase the survival rate of critically ill patients. This prospective study was carried out on 885 patients in the ICU of Mureș County Clinical Hospital, Romania. After applying inclusion and exclusion criteria, a total of 54 patients were included. Patients were monitored during hospitalization and at 6-month follow-up. We analyzed the relationship between invasive mechanical ventilation (IMV) and non-invasive mechanical ventilation (NIMV) and radiological changes on thoracic CT scans performed at 6-month follow-up and found no significant association. Regarding paraclinical analysis, there was a statistically significant association between patients grouped by IMV and ferritin level on day 1 of admission (p = 0.034), and between patients grouped by PaO2/FiO2 ratio with metabolic syndrome (p = 0.03) and the level of procalcitonin (p = 0.01). A significant proportion of patients with COVID-19 admitted to the ICU developed pulmonary fibrosis as observed at a 6-month evaluation. Patients with oxygen supplementation or mechanical ventilation require dynamic monitoring and radiological investigations, as there is a possibility of long-term pulmonary fibrosis that requires pharmacological interventions and finding new therapeutic alternatives.
摘要：
从SARS-CoV-2的首次报道，2019年底到现在，根据世界卫生组织（WHO）的报告，与COVID-19相关的全球死亡率已达到6,952,522例死亡。早期插管和机械通气可提高危重患者的生存率。这项前瞻性研究是在穆雷县临床医院ICU的885名患者中进行的，罗马尼亚。在应用纳入和排除标准后，共纳入54例患者.在住院期间和6个月随访时对患者进行监测。我们分析了有创机械通气（IMV）和无创机械通气（NIMV）与6个月随访时胸部CT扫描的放射学变化之间的关系，发现没有显着关联。关于临床分析，入院第1天按IMV和铁蛋白水平分组的患者之间存在统计学上的显着关联（p=0.034），以及按PaO2/FiO2比值与代谢综合征（p=0.03）和降钙素原水平（p=0.01）分组的患者之间。在6个月的评估中观察到，入住ICU的COVID-19患者中有很大一部分发生了肺纤维化。补充氧气或机械通气的患者需要动态监测和放射学检查，因为存在长期肺纤维化的可能性，需要药物干预和寻找新的治疗替代方案。
