Critical illness-related corticosteroid insufficiency (CIRCI) among patients with COVID-19 at a tertiary hospital: Clinical characteristics and outcomes
doi.org/10.15605/jafes.038.01.02
- Author:
Anna Elvira Arcellana
1
;
Kenneth Wilson Lim
1
;
Marlon Arcegono
1
;
Cecilia Jimeno
1
Author Information
1. University of the Philippines Philippine General Hospital
- Publication Type:Journal Article
- MeSH:
adrenal insufficiency;
COVID-19;
critical illness;
shock
- From:
Journal of the ASEAN Federation of Endocrine Societies
2023;38(1):90-99
- CountryPhilippines
- Language:English
-
Abstract:
Objectives:Among critically ill patients, there is usually impairment of the hypothalamic-pituitary- adrenal axis, leading to a condition known as critical illness-related corticosteroid insufficiency (CIRCI). The aims of this investigation are to determine the incidence of and characterize CIRCI among patients with COVID-19 as well as to analyze the outcomes of these critically ill patients.
Methodology:This is a single-center, retrospective, cohort study that investigated the occurrence of CIRCI among critically ill patients infected with COVID-19.
Results:In this cohort, there were 145 COVID-19 positive patients with refractory shock included, which reflects that 22.94% of the COVID-19 admissions have probable CIRCI.
Patients who were given corticosteroids were found to have statistically significant longer median days on ventilator (p= 0.001). However, those on the corticosteroid arm were at higher risk of morbidity and mortality and a greater proportion of patients with organ dysfunction.
Multivariable logistic regression analysis revealed that SOFA score was a significant predictor of mortality in CIRCI (p=0.013).
Conclusion:CIRCI has a unique presentation among COVID-19 patients because of the presence of a high level of inflammation in this life-threatening infection. It possibly is a harbinger of markedly increased risk of mortality in these patients.
- Full text:2421-Article Text-23647-1-10-20230714.pdf
