335
2020년 제 71차 대한내과학회 추계학술대회
￭S-292 ￭ Clinical characteristics that progress to acute respiratory distress syndrome
in COVID-19 patients
대구가톨릭대학교 의과대학 내과학교실 이상민, 김은진
Background/Aims: Daegu was the center of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks. COVID-19 presents with a variety of clinical patterns; approximately 5% of patients develop respiratory failure requiring intensive care. We investigated the differences of clinical characteristics between acute respiratory distress syndrome (ARDS) and non-ARDS groups in patients with COVID-19.
Methods: We retrospectively reviewed the medical records of patients who were confirmed positive by SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) of nasopharyngeal swab or sputum samples at Daegu Catholic University Medical Center. Inclusion criteria were adults aged over 18 years who were admitted to our hospital due to positive results of SARS-CoV-2 RT-PCR. Exclusion criteria were patients who wanted do-not-intubate status. ARDS was defined as an arterial partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratio (PF ratio) of ≤ 300 in accordance with the Berlin definition.
Results: A total of 133 patients were admitted to our hospital from February 18, 2020 to May 22, 2020. According to the exclusion criteria, a total of 8 patients were excluded. Among 125 patients, 11 patients progressed to ARDS (ARDS group), 114 patients was not progressed to ARDS (non-ARDS group). There was a significant difference between ARDS and non-ARDS groups in age, so we performed a 1:3 analysis with age correction between the two groups. At the time of hospitalization, oxygen saturation and saturation/fraction of inspired oxygen (SF ratio) was significantly different in the two groups (p<0.001, respectively). The National Early Warning Score (NEWS) at hospitalization was significantly different in the two groups (p<0.001). Body temperature and the number of oxygen therapy was significantly different (p=0.004, 0.001, respectively) (Table 1). Figure 1 shows the clinical course of ARDS patients after onset of symptom. Duration of hospital stay was significantly longer in ARDS than in non-ARDS (p=0.02).
Conclusions: There were significant differences in SF ratio, NEWS, body temperature and the number of O2 therapy between ARDS and non-ARDS groups.
