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.
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.
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DOI：
10.3390/metabo10100386
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发表时间：
2020-09-28
期刊：
影响因子：
4.1
通讯作者：
Dimopoulou I
中科院分区：
文献类型：
--
作者：
Vassiliou AG;Jahaj E;Ilias I;Markaki V;Malachias S;Vrettou C;Ischaki E;Mastora Z;Douka E;Keskinidou C;Tsipilis S;Vassiliadi DA;Kotanidou A;Dimopoulou I
冠状病毒病-19(新冠肺炎)继续是世界范围内的健康威胁。血乳酸升高在重症监护病房(ICU)患者中很常见；然而，它与ICU新冠肺炎患者预后的相关性目前仍不清楚。在这项回顾性的观察性研究中，我们评估了乳酸盐是否与新冠肺炎患者的预后有关。对45例确诊为新冠肺炎肺炎的患者在ICU入院时和此后每天至第14天测定血乳酸。ICU入院时计算急性生理与慢性健康评分(APACHE II)，入院时及隔日评定序贯器官衰竭评分(SOFA)。根据28天的ICU死亡率(24.4%)，将队列分为幸存者和死亡者。COX回归分析显示，在APACHE II存在的情况下，入院时的最大乳酸与28天的ICU死亡率随时间独立相关(RR=2.45，P=0.008)。检测28天ICU死亡率的曲线下面积为0.77(p=0.008)。混合模型分析显示，死亡患者的日均乳酸水平较高(p<；0.0001)；应用于SOFA评分的模型显示出类似的时间模式。因此，初始血乳酸是新冠肺炎ICU患者的独立预后预测因素。乳酸的时间进程反映了器官功能障碍，并与不良的临床结果有关。
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.
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影响因子：
8.1
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