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Lactate Kinetics Reflect Organ Dysfunction and Are Associated with Adverse Outcomes in Intensive Care Unit Patients with COVID-19 Pneumonia: Preliminary Results from a GREEK Single-Centre Study
Coronavirus disease-19 (COVID-19) continues to be a health threat worldwide. Increased blood lactate is common in intensive care unit (ICU) patients; however, its association with outcomes in ICU COVID-19 patients remains currently unexplored. In this retrospective, observational study we assessed w...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7599563/ https://www.ncbi.nlm.nih.gov/pubmed/32998323 http://dx.doi.org/10.3390/metabo10100386 |
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author | Vassiliou, Alice G. Jahaj, Edison Ilias, Ioannis Markaki, Vassiliki Malachias, Sotirios Vrettou, Charikleia Ischaki, Eleni Mastora, Zafeiria Douka, Evangelia Keskinidou, Chrysi Tsipilis, Stamatios Vassiliadi, Dimitra A. Kotanidou, Anastasia Dimopoulou, Ioanna |
author_facet | Vassiliou, Alice G. Jahaj, Edison Ilias, Ioannis Markaki, Vassiliki Malachias, Sotirios Vrettou, Charikleia Ischaki, Eleni Mastora, Zafeiria Douka, Evangelia Keskinidou, Chrysi Tsipilis, Stamatios Vassiliadi, Dimitra A. Kotanidou, Anastasia Dimopoulou, Ioanna |
author_sort | Vassiliou, Alice G. |
collection | PubMed |
description | Coronavirus disease-19 (COVID-19) continues to be a health threat worldwide. Increased blood lactate is common in intensive care unit (ICU) patients; however, its association with outcomes in ICU COVID-19 patients remains currently unexplored. In this retrospective, observational study we assessed whether lactate is associated with outcomes in COVID-19 patients. Blood lactate was measured on ICU admission and thereafter daily up to day 14 in 45 patients with confirmed COVID-19 pneumonia. Acute physiology and chronic health evaluation (APACHE II) was calculated on ICU admission, and sequential organ failure assessment (SOFA) score was assessed on admission and every second day. The cohort was divided into survivors and non-survivors based on 28-day ICU mortality (24.4%). Cox regression analysis revealed that maximum lactate on admission was independently related to 28-day ICU mortality with time in the presence of APACHE II (RR = 2.45, p = 0.008). Lactate’s area under the curve for detecting 28-day ICU mortality was 0.77 (p = 0.008). Mixed model analysis showed that mean daily lactate levels were higher in non-survivors (p < 0.0001); the model applied on SOFA scores showed a similar time pattern. Thus, initial blood lactate was an independent outcome predictor in COVID-19 ICU patients. The time course of lactate mirrors organ dysfunction and is associated with poor clinical outcomes. |
format | Online Article Text |
id | pubmed-7599563 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-75995632020-11-01 Lactate Kinetics Reflect Organ Dysfunction and Are Associated with Adverse Outcomes in Intensive Care Unit Patients with COVID-19 Pneumonia: Preliminary Results from a GREEK Single-Centre Study Vassiliou, Alice G. Jahaj, Edison Ilias, Ioannis Markaki, Vassiliki Malachias, Sotirios Vrettou, Charikleia Ischaki, Eleni Mastora, Zafeiria Douka, Evangelia Keskinidou, Chrysi Tsipilis, Stamatios Vassiliadi, Dimitra A. Kotanidou, Anastasia Dimopoulou, Ioanna Metabolites Article Coronavirus disease-19 (COVID-19) continues to be a health threat worldwide. Increased blood lactate is common in intensive care unit (ICU) patients; however, its association with outcomes in ICU COVID-19 patients remains currently unexplored. In this retrospective, observational study we assessed whether lactate is associated with outcomes in COVID-19 patients. Blood lactate was measured on ICU admission and thereafter daily up to day 14 in 45 patients with confirmed COVID-19 pneumonia. Acute physiology and chronic health evaluation (APACHE II) was calculated on ICU admission, and sequential organ failure assessment (SOFA) score was assessed on admission and every second day. The cohort was divided into survivors and non-survivors based on 28-day ICU mortality (24.4%). Cox regression analysis revealed that maximum lactate on admission was independently related to 28-day ICU mortality with time in the presence of APACHE II (RR = 2.45, p = 0.008). Lactate’s area under the curve for detecting 28-day ICU mortality was 0.77 (p = 0.008). Mixed model analysis showed that mean daily lactate levels were higher in non-survivors (p < 0.0001); the model applied on SOFA scores showed a similar time pattern. Thus, initial blood lactate was an independent outcome predictor in COVID-19 ICU patients. The time course of lactate mirrors organ dysfunction and is associated with poor clinical outcomes. MDPI 2020-09-28 /pmc/articles/PMC7599563/ /pubmed/32998323 http://dx.doi.org/10.3390/metabo10100386 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Vassiliou, Alice G. Jahaj, Edison Ilias, Ioannis Markaki, Vassiliki Malachias, Sotirios Vrettou, Charikleia Ischaki, Eleni Mastora, Zafeiria Douka, Evangelia Keskinidou, Chrysi Tsipilis, Stamatios Vassiliadi, Dimitra A. Kotanidou, Anastasia Dimopoulou, Ioanna Lactate Kinetics Reflect Organ Dysfunction and Are Associated with Adverse Outcomes in Intensive Care Unit Patients with COVID-19 Pneumonia: Preliminary Results from a GREEK Single-Centre Study |
title | Lactate Kinetics Reflect Organ Dysfunction and Are Associated with Adverse Outcomes in Intensive Care Unit Patients with COVID-19 Pneumonia: Preliminary Results from a GREEK Single-Centre Study |
title_full | Lactate Kinetics Reflect Organ Dysfunction and Are Associated with Adverse Outcomes in Intensive Care Unit Patients with COVID-19 Pneumonia: Preliminary Results from a GREEK Single-Centre Study |
title_fullStr | Lactate Kinetics Reflect Organ Dysfunction and Are Associated with Adverse Outcomes in Intensive Care Unit Patients with COVID-19 Pneumonia: Preliminary Results from a GREEK Single-Centre Study |
title_full_unstemmed | Lactate Kinetics Reflect Organ Dysfunction and Are Associated with Adverse Outcomes in Intensive Care Unit Patients with COVID-19 Pneumonia: Preliminary Results from a GREEK Single-Centre Study |
title_short | Lactate Kinetics Reflect Organ Dysfunction and Are Associated with Adverse Outcomes in Intensive Care Unit Patients with COVID-19 Pneumonia: Preliminary Results from a GREEK Single-Centre Study |
title_sort | lactate kinetics reflect organ dysfunction and are associated with adverse outcomes in intensive care unit patients with covid-19 pneumonia: preliminary results from a greek single-centre study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7599563/ https://www.ncbi.nlm.nih.gov/pubmed/32998323 http://dx.doi.org/10.3390/metabo10100386 |
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