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

Metabolites

Ioannis Ilias¹  Edison Jahaj¹  Eleni Ischaki¹  Vassiliki Markaki¹  DimitraA. Vassiliadi¹  AliceG. Vassiliou¹  Stamatios Tsipilis¹  Sotirios Malachias¹  Chrysi Keskinidou¹  Ioanna Dimopoulou¹  Charikleia Vrettou¹  Zafeiria Mastora¹  Evangelia Douka¹  Anastasia Kotanidou¹ 

[1] First Department of Critical Care Medicine & Pulmonary Services, Medical School of National & Kapodistrian University of Athens, Evangelismos Hospital, 10676 Athens, Greece;

关键词: COVID-19;    acute respiratory distress syndrome;    lactate;    SOFA;    mortality;   

DOI  :  10.3390/metabo10100386

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown