PREDIKTORI TEŽINE BOLESTI KOD BOLESNIKA SA COVID-19 BOLEŠĆU

  • Milivoje Djurić Opšta bolnica „Laza K. Lazarević” Šabac, Srbija
  • Mirjana Makević Djurić Dom zdravlja „Darinka Lukić” Koceljeva, Srbija
  • Ivana Kavećan Institut za zaštitu dece i omladine Vojvodine, Medicinski fakultet u Novom Sadu, Univerzitet u Novom Sadu, Novi Sad, Srbija
  • Isidora Vujčić Institut za epidemiologiju, Medicinski fakultet u Beogradu, Univerzitet u Beogradu, Beograd, Srbija
  • Nataša Maksimović Institut za epidemiologiju, Medicinski fakultet u Beogradu, Univerzitet u Beogradu, Beograd, Srbija
  • Katarina Maksimović Institut za epidemiologiju, Medicinski fakultet u Beogradu, Univerzitet u Beogradu, Beograd, Srbija
  • Biljana Georgievski-Brkić Specijalna bolnica „Sveti Sava”, Beograd, Srbija
  • Jadranka Maksimović Institut za epidemiologiju, Univerzitet u Beogradu, Beograd, Republika Srbija
DOI: https://doi.org/10.5937/zdravzast53-54935
Ključne reči: COVID-19, komorbiditeti, faktori rzika, težina bolesti, potpomognuta ventilacija

Sažetak


Uvod/cilj: U kliničkoj slici COVID-19 dominira respiratorna simptomatologija, ali se u osnovi radi o multisistemskom poremećaju. Cilj ove studije je bio da se identifikuju prediktori teških oblika COVID-19 definisanih kao potreba za potpomognutom ventilacijom (neinvazivna ili invazivna mehanička ventilacija).

Metode: Sprovedena je retrospektivna kohortna studija u Opštoj bolnici „Laza K. Lazarević“ u Šapcu u periodu od 1.4.2020. do 15.11.2020. godine. Odnos između demografskih i kliničkih parametara pacijenata i potrebe za asistiranom ventilacijom ispitan je logističkom regresionom analizom.

Rezultati: Studijom je obuhvaćeno 516 pacijenata, 334 ispitanika muškog pola (64,7%), starosti 60 i više godina (52,7%). Najčešći prijavljeni simptomi bili su groznica (89,0%) i generalizovana slabost (68,8%). Mehanička ventilacija je bila potrebna za 44 pacijenta, od kojih su većina bili muškarci (64,7%). Dominantni komorbiditeti u grupi sa mehaničkom ventilacijom bili su hipertenzija (63,6%) i dijabetes (22,7%). Prema multivarijantnoj analizi, nezavisni faktori rizika za potpomognutu ventilaciju bili su: febrilnost (p=0,022), trajanje bolesti više od sedam dana pre hospitalizacije (p=0,023), oksigena saturacija (sO2) na prijemu <90% (p=0,002), aritmija (p=0,001), leukocitoza (p=0,034), i CRP>50 mg/l (p=0,002).

Zaključak: Rizik od potpomognute ventilacije je bio veći kod febrilnih pacijenata, sa oksigenom saturacijom manjom od 90% na prijemu u bolnicu, trajanjem bolesti više od sedam dana pre hospitalizacije, aritmijama, leukocitozom, i CRP većim od 50 mg/l.

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Objavljeno
2025/02/12
Broj časopisa
Vol. 53 Br. 4 (2024): ZDRAVSTVENA ZAŠTITA
Rubrika
Originalni rad