entered in FIA. It is the conclusion of a review of 58 studies and 44,305 patients, published in ‘Anaesthesia’, the journal of the
Association of Anesthetists.
Contrary to some previous research, being a man and having a high body mass index (BMI) is not associated with increased mortality from Covid-19 in ICU patients. However, the meta-analysis, conducted by Dr. Bruce Biccard (Groote Schuur Hospital and University of Cape Town, South Africa) and his colleagues, has found a wide range of factors that are related.
Covid-19 patients in the ICU had a 40% more likely to die if they had a history of smoking54% more likely if they had high blood pressure, 41% more likely if they had diabetes, 75% more likely if they had respiratory disease, about twice as likely to die if they had cardiovascular disease or cancer, and 2.4 times more likely to die with kidney disease than patients without these risk factors.
Other factors associated with an increased risk of death were the severity of organ failure, the need for mechanical ventilation (2.5 times compared to non-ventilated ICU patients), and also elevated white blood cell counts and other markers of inflammation.
The authors consider that age can effectively lead to frailty in patients with Covid-19, which impacts a person’s physiological reserve to overcome a critical illness. Risk factors for hypertension, smoking, and respiratory diseases may be related by their association with angiotensin converting enzyme (ACE) receptors in the body, as seen by increased expression of ACE-2 receptors among smokers. and patients with chronic obstructive pulmonary disease (COPD). The relationship between hypertension and cardiovascular disease with increased mortality may have to do with the risk of cardiac injury associated with the systemic inflammatory response to Covid-19 infection.
«The findings confirm the association between diabetes, cardiovascular and respiratory diseases with mortality in patients with Covid-19. However, previously reported relationships between being male and having a high BMI and poorer outcomes are not supported by this meta-analysis of patients admitted to the ICU. This meta-analysis provides a large sample size regarding these risk factors and is a robust estimate of the risk associated with male gender and BMI, ”the authors note.