Solapamiento de los síndromes de Guillain-Barré y Miller Fisher como complicación inusual de la COVID-19. Presentación de un caso

Abstract

Background: The COVID-19 pandemic has had a devastating impact on the world, mainly during the first year of the pandemic, where strategies such as vaccination were not available. Information on the outcomes of patients admitted to the intensive care unit (ICU) in Colombia is scarce. Our main objective was to characterize critically ill patients with COVID-19 in our region. Methods: We conducted a single-center retrospective observational study in which we included patients with COVID-19 confirmed by RT-PCR who were admitted to the adult ICU between March 18, 2020 and March 18, 2021, in Quindío, Colombia. We identify the clinical and laboratory characteristics at admission, the support used, and their relationship with mortality during ICU hospitalization. Results: Three hundred and fifty-nine patients with a confirmed diagnosis of COVID-19 were admitted, 64% men, mean age was 62.7 years (SD ± 12.3), body mass index 27.9 kg/m2 (±5.8), SOFA score was 7.6 (±3.12), Pa/FiO<inf>2</inf> 96.2 (±62.3), and lung compliance 30.5 ml/cmH<inf>2</inf>O (±18.4). Mortality was 60%. The variables with the highest mortality association were obesity OR: 2.38 (95% CI: 1.39–4.09, p: <.001), Glasgow coma scale at admission <12: 17.5, (5.21–58.8, p: <.001), PaFiO<inf>2</inf> <100: 5.63, (3.38–9.39, p: <.001), static lung compliance less than 50 ml/cmH<inf>2</inf>O: 3.54, (3.38–9.39, p: <.001), SOFA score >5: 3.75 (2.19–6.42, p: <0.001), ferritin > 1000: 2.58, (1.66–4.02, p: <.001), C-reactive protein > 5: 2.52 (1.42–4.26, p: <.001), and LDH > 280: 2.71 (1.55–4.74, p: <.001). Patients who required PEEP > 10 cmH<inf>2</inf>O: 2.34 (1.48–3.70, p: <.001), FiO<inf>2</inf> > 60%: 4.01, (2.46–6.53, p: <.001), and ventilation in the prone position. Conclusion: Mortality in the first year of the pandemic in our region was high, mainly associated with obesity, inflammation, altered mental status upon admission, and increased lung elastance.