Acute and Critical Care

Original Article

Infection
In-hospital mortality prediction using frailty scale and severity score in elderly patients with severe COVID-19: Yong Sub Na, Jin Hyoung Kim, Moon Seong Baek, Won-Young Kim, Ae-Rin Baek, Bo young Lee, Gil Myeong Seong, Song-I Lee; Acute Crit Care. 2022;37(3):303-311. Published online July 5, 2022; DOI: https://doi.org/10.4266/acc.2022.00017

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Background
Elderly patients with coronavirus disease 2019 (COVID-19) have a high disease severity and mortality. However, the use of the frailty scale and severity score to predict in-hospital mortality in the elderly is not well established. Therefore, in this study, we investigated the use of these scores in COVID-19 cases in the elderly.
Methods
This multicenter retrospective study included severe COVID-19 patients admitted to seven hospitals in Republic of Korea from February 2020 to February 2021. We evaluated patients’ Acute Physiology and Chronic Health Evaluation (APACHE) II score; confusion, urea nitrogen, respiratory rate, blood pressure, 65 years of age and older (CURB-65) score; modified early warning score (MEWS); Sequential Organ Failure Assessment (SOFA) score; clinical frailty scale (CFS) score; and Charlson comorbidity index (CCI). We evaluated the predictive value using receiver operating characteristic (ROC) curve analysis.
Results
The study included 318 elderly patients with severe COVID-19 of whom 237 (74.5%) were survivors and 81 (25.5%) were non-survivors. The non-survivor group was older and had more comorbidities than the survivor group. The CFS, CCI, APACHE II, SOFA, CURB-65, and MEWS scores were higher in the non-survivor group than in the survivor group. When analyzed using the ROC curve, SOFA score showed the best performance in predicting the prognosis of elderly patients (area under the curve=0.766, P<0.001). CFS and SOFA scores were associated with in-hospital mortality in the multivariate analysis.
Conclusions
The SOFA score is an efficient tool for assessing in-hospital mortality in elderly patients with severe COVID-19.

Citations

Citations to this article as recorded by

Quadriceps Muscle Layer Thickness and its association with frailty in critically ill patients: A prospective observational study
Vijay Sundarsingh, R. Manoj Kumar, Manjunath Kulkarni, Debasis Pradhan, Pramela Renisha Rodrigues, Nishanth Baliga, Mamata Prasad, Pooja Yadav, Monish Thomas, Tania Eltrida Pinto
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Risk factors for progressing to critical illness in patients with hospital-acquired COVID-19
Kyung-Eui Lee, Jinwoo Lee, Sang-Min Lee, Hong Yeul Lee
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Omicron, Long-COVID, and the Safety of Elective Surgery for Adults and Children: Joint Guidance from the Therapeutics and Guidelines Committee of the Surgical Infection Society and the Surgery Strategic Clinical Network, Alberta Health Services
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Banu Buyukaydin, Tahsin Karaaslan, Omer Uysal
AGING MEDICINE.2023; 6(1): 56. CrossRef
Atypical presentation of COVID-19 in older patients is associated with frailty but not with adverse outcomes
Joy E. van Son, Elisabeth C. P. Kahn, Jessica M. van der Bol, Dennis G. Barten, Laura C. Blomaard, Carmen van Dam, Jacobien Ellerbroek, Steffy W. M. Jansen, Anita Lekx, Carolien M. J. van der Linden, Roy Looman, Huub A. A. M. Maas, Francesco U. S. Mattace
European Geriatric Medicine.2023;[Epub] CrossRef
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Ana Luisa Corona-Nakamura, Martha Judith Arias-Merino, Rayo Morfín-Otero, Guillermo Rodriguez-Zavala, Alfredo León-Gil, Juan Ramsés Camarillo-Escalera, Idarmis Brisseida Reyes-Cortés, María Gisela Valdovinos-Ortega, Erick René Nava-Escobar, Ana María de l
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Modified Early Warning Score: Clinical Deterioration of Mexican Patients Hospitalized with COVID-19 and Chronic Disease
Nicolás Santiago González, María de Lourdes García-Hernández, Patricia Cruz-Bello, Lorena Chaparro-Díaz, María de Lourdes Rico-González, Yolanda Hernández-Ortega
Healthcare.2023; 11(19): 2654. CrossRef
Risk Factors and Predictive Model for Mortality of Hospitalized COVID-19 Elderly Patients from a Tertiary Care Hospital in Thailand
Mallika Chuansangeam, Bunyarat Srithan, Pattharawin Pattharanitima, Pawit Phadungsaksawasdi
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Case Report

Pulmonary
A fatal case report of invasive pulmonary aspergillosis and mucormycosis coinfection in an immunocompetent patient with coronavirus disease 2019 in Korea: Jin Hyoung Kim, Misung Kim, Soyeoun Lim, Sun Young Park, Yangjin Jegal, Taehoon Lee, Byung Ju Kang; Acute Crit Care. 2023;38(3):382-388. Published online June 27, 2022; DOI: https://doi.org/10.4266/acc.2021.01340

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120 Download
5 Web of Science
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Abstract PDF

Systemic glucocorticoid treatment is highly recommended in critically ill coronavirus disease 2019 (COVID-19) patients. However, secondary fungal infections are of concern in such patients. Here, we describe the first case of COVID-19-associated invasive pulmonary aspergillosis (CAPA) and COVID-19-associated mucormycosis (CAM) coinfection in a COVID-19 positive immunocompetent patient in Korea. A 69-year-old man was admitted to our hospital with COVID-19 pneumonia. He had no underlying comorbidities and was not taking medications. He received remdesivir, dexamethasone, and antibiotic therapy under mechanical ventilation. Although his condition improved temporarily, multiple cavities were observed on chest computed tomography, and Aspergillus fumigatus was cultured from tracheal aspiration culture. He was diagnosed with probable CAPA and received voriconazole therapy. However, his condition was not significantly improved despite having received voriconazole therapy for 4 weeks. After release from COVID-19 quarantine, he underwent bronchoscopy examination and was then finally diagnosed with CAPA and CAM coinfection on bronchoscopic biopsy. Antifungal treatment was changed to liposomal amphotericin B. However, his progress deteriorated, and he died 4 months after admission. This case highlights that clinical suspicion and active checkups are required to diagnose secondary fungal infections in immunocompetent COVID-19 patients who receive concurrent glucocorticoid therapy.

Citations

Citations to this article as recorded by

Incidence and Temporal Dynamics of Combined Infections in SARS-CoV-2-Infected Patients With Risk Factors for Severe Complications
Sin Young Ham, Seungjae Lee, Min-Kyung Kim, Jaehyun Jeon, Eunyoung Lee, Subin Kim, Jae-Phil Choi, Hee-Chang Jang, Sang-Won Park
Journal of Korean Medical Science.2025;[Epub] CrossRef
Mixed Aspergillosis and Mucormycosis Infections in Patients with COVID-19: Case Series and Literature Review
Elahe Sasani, Farzad Pakdel, Sadegh Khodavaisy, Mohammadreza Salehi, Amir Salami, Marjan Sohrabi, Pouyan Aminishakiba, Iman Amirafzali, Arezoo Salami Khaneshan
Mycopathologia.2024;[Epub] CrossRef
Prevalence of co‐existent COVID‐19‐associated pulmonary aspergillosis (CAPA) and its impact on early mortality in patients with COVID‐19‐associated pulmonary mucormycosis (CAPM)
Valliappan Muthu, Ritesh Agarwal, Shivaprakash Mandya Rudramurthy, Deepak Thangaraju, Manoj Radhakishan Shevkani, Atul K. Patel, Prakash Srinivas Shastri, Ashwini Tayade, Sudhir Bhandari, Vishwanath Gella, Jayanthi Savio, Surabhi Madan, Vinaykumar Hallur,
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Sang Hyun Ra, Ji Yeun Kim, Joon Seon Song, Hyeon Mu Jang, Euijin Chang, Seongman Bae, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Sung-Han Kim
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Successful treatment of mixed pulmonary Aspergillus and Mucor infection using intrabronchial amphotericin B infusion: a case report and literature review
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The impact of pulmonary tuberculosis on SARS-CoV-2 infection: a nationwide cohort study
Sang Hwan Lee, Yun Jin Kim, Jaehoon Oh, Hyunggoo Kang, Kyung Hun Yoo, Byuk Sung Ko, Tae Ho Lim, Bo-Guen Kim, Hyun Lee, Sang-Heon Kim, Jang Won Sohn, Ho Joo Yoon, Hayoung Choi, Yongil Cho, Dong Won Park
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Dual Disseminated Aspergillosis and Mucormycosis Diagnosed at Autopsy: A Report of Two Cases of Coinfection and a Review of the Literature
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