The Clinical Respiratory Journal (Jun 2023)

The risk of venous thromboembolism and blood hyperlactatemia is associated with increased mortality among critically ill patients with Covid‐19

  • Amal F. Alshammary,
  • Hassan M. AlQarni,
  • Raed Farzan,
  • Imran Ali Khan,
  • Vishal Vennu

DOI
https://doi.org/10.1111/crj.13628
Journal volume & issue
Vol. 17, no. 6
pp. 580 – 588

Abstract

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Abstract Introduction Coronavirus disease 2019 (Covid‐19) following venous thromboembolism (VTE) and blood hyperlactatemia are associated with higher mortality. However, reliable biomarkers for this association remain to be elucidated. This study investigated the associations of VTE risk and blood hyperlactatemia with mortality among critically ill Covid‐19 patients admitted to the intensive care unit (ICU). Methods In this single‐centre retrospective study, we included 171 patients aged ≥18 years with confirmed Covid‐19 admitted to the ICU at a tertiary healthcare clinic in the Eastern region of Saudi Arabia between 1 March 2020 and 31 January 2021. Patients were divided into two groups: survivor and non‐survivor. The survivors have been identified as the patients discharged from the ICU alive. The VTE risk was defined using a Padua prediction score (PPS) >4. The blood lactate concentration (BLC) cut‐off value >2 mmol/L was used to determine the blood hyperlactatemia. Results Multi‐factor Cox analysis showed that PPS >4 and BLC >2 mmol/L were more likely to be significantly associated with higher odds of ICU mortality in critically ill Covid‐19 patients (hazard ratio [HR] = 2.80, 95% confidence interval [CI] = 1.00–8.08, p = 0.050; HR = 3.87, 95% CI = 1.12–13.45, p = 0.033, respectively). The Area under the Curve for VTE and blood hyperlactatemia were 0.62 and 0.85, respectively. Conclusion VTE risk and blood hyperlactatemia have been associated with a higher mortality risk in critically ill Covid‐19 patients who are hospitalized in the ICU in Saudi Arabia. According to our findings, these people needed more effective VTE prevention strategies based on a personalized assessment of their risk of bleeding. Moreover, persons without diabetes and other groups with a high risk of dying from COVID‐19 may be recognized by measuring glucose as having elevated glucose and lactate jointly.

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