infection | The Journal of Critical Care Medicine

Variability of Steroid Prescription for COVID-19 Associated Pneumonia in Real-Life, Non-Trial Settings

Rashid Nadeem¹, Islam Bon¹, Doaa Algohary¹, Mohd Kafeel Khan¹, Nilesh Gundawar¹, Mohammed Abdullah¹, Ekta Sharma¹, Moatz Galal Elzeiny¹, Mayada Mahmoud¹, Ashraf Elhoufi¹, Yusra Omar Alshaikh Sayed Ahmed¹, Gloria Gheno², Maged Talaat Salama Khalil¹, Tamseela Hussain²

1 Dubai Hospital, Dubai, UAE
2 Ronin Institute for Independent Scholarship, Montclair, New Jersey, USA

DOI: 10.2478/jccm-2022-0025

The RECOVERY study documented lower 28-day mortality with the use of dexamethasone in hospitalized patients on invasive mechanical ventilation or oxygen with COVID-19 Pneumonia. We aimed to examine the practice patterns of steroids use, and their impact on mortality and length of stay in ICU. We retrospectively examined records of all patients with confirmed Covid 19 pneumonia admitted to the ICU of Dubai hospital from January 1st, 2020 – June 30th, 2020. We assigned patients to four groups (No steroids, low dose, medium dose, and high dose steroids). The primary clinical variable of interest was doses of steroids. Secondary outcomes were 28-day mortality and length of stay in ICU”. We found variability in doses of steroid treatment. The most frequently used dose was the high dose. Patients who survived were on significantly higher doses of steroids and had significantly longer stays in ICU. The prescription of steroids in Covid-19 ARDS is variable. The dose of steroids impacts mortality rate and length of stay in ICU, although patients treated with high dose steroids seem to stay more days in ICU.

The Role of Angiopoietine-2 in the Diagnosis and Prognosis of Sepsis

Janos Szederjesi¹, Emoke Almasy¹, Alexandra Lazar¹, Adina Huțanu², Anca Georgescu³

¹ University of Medicine and Pharmacy Tîrgu Mureş, Romania, Discipline of Intensive Care, 38 Gheorghe Marinescu street, Tirgu Mures, 540139, Romania
² County Clinical Emergency Hospital Tirgu Mures, Romania, 50 Gheorghe Marinescu street Tirgu Mures, 540139, Romania
³ University of Medicine and Pharmacy Tîrgu Mureş, Romania, Discipline of Infectious Diseases, 38 Gheorghe Marinescu street, Tirgu Mures, 540139, Romania

DOI: 10.1515/jccm-2015-0004

Introduction: Angiopoietin-2 (ANG-2) is a new biomarker whose blood-serum values increase in sepsis and its expression is elevated in line with the severity of the degree of inflammation. The aim of this study was to identify the diagnostic role of ANG-2 in patients with non-surgical sepsis addmitted to an intensive care unit.
Material and methods: This was a prospective randomized study including 74 patients admitted in the Clinic of Intensive Care of the County Clinical Emergency Hospital Tirgu Mureș, divided into two groups: Group S: patients with sepsis (n=40, 54%) and Group C: control, without sepsis (n=34, 46%). ANG-2 levels were determined in both groups.
Results: From the Group S, 14 patients (35%) had positive haemocultures. ANG-2 values varied between 1 and 43 ng/mL, with an average of 6.0 ng/mL in patients without sepsis and 10.38 ng/mL in patients with sepsis (p=0.021). A positive correlation between ANG-2 and SAPS II, SOFA and APACHE II severity scores was demonstrated, as was a positive correlation between serum levels of ANG-2 and procalcitonine. ANG-2 had a 5.71% specificity and 74.36% sensitivity for diagnosis of sepsis.
Conclusions: ANG-2 serum levels were elevated in sepsis, being well correlated with PCT values and prognostic scores. ANG-2 should be considered as a useful biomarker for the diagnosis and the prognosis of this pathology.