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Medicina crítica (Colegio Mexicano de Medicina Crítica)
versão impressa ISSN 2448-8909
Resumo
PEREZ FERNANDEZ, Oyuky; MENDOZA PORTILLO, Elizabeth e MENDOZA RODRIGUEZ, Martin. Delta uric acid as a predicator of severity in patients with SARS-CoV-2. Med. crít. (Col. Mex. Med. Crít.) [online]. 2022, vol.36, n.3, pp.142-147. Epub 05-Dez-2022. ISSN 2448-8909. https://doi.org/10.35366/105379.
Introduction:
SARS-CoV-2 represents the first cause of current mortality in the Mexican population, globally it has accumulated 1’919,126 deaths. The regions with the most deaths are America (47%), Europe (33%). Until week two of 2021 in Mexico, 1’541,633 cases were estimated, with Mexico City being the most affected entity, until that moment 18,443 deaths had been registered, with a hospital need of 80%, and with a high demand for hospitalization in the service of Intensive Care Unit (ICU). For this reason, the need arises for new early markers of severity and prognosis.
Objective:
To correlate the uric acid delta (DAU) with mortality in patients with SARS-CoV-2 treated in the ICU, as well as its relationship with other variables of severity.
Material and methods:
A longitudinal study was carried out in the ICU with 71 patients and study variables: demographic, comorbidities, days of ICU stay, days of mechanical ventilation (MV), predictive mortality scale, initial uric acid and final uric acid, DAU; outcome: mortality.
Results:
Of the participants, 69% were men, 31% women, mean age of 54.35 years (± 10.28), uric acid at admission of 3.9 mg/dL (± 1.74), uric acid at discharge of 2.89 mg/dL (± 1.70), mean uric acid delta of 1.077 mg/dL (± 1.59 mg/dL), APACHE II at entry of 18.35 points (± 9.04) at discharge of 22.95 points (± 19.68), global mortality of 50.7%, of which 78.67% required mechanical ventilation (MV) and 21.12% did not require. The Spearman correlation for DAU and mortality was r = -0.34, the determination index r2 = 0.13, with significance p = 0.004, (CI) 95%.
Conclusions:
The correlation between the DAU with the mortality of the patients with SARS-CoV-2 was demonstrated with adequate statistical significance at a cut-off interval of 1-1.5 mg/dL, and a mortality of 50.7%. Additionally, it was shown that said interval had a correlation with the start of mechanical ventilation. It was identified that if there is a relationship between the APACHE II score and SARS-CoV-2 mortality, for this study a score greater than 18 demonstrated the best statistical significance.
Palavras-chave : Uric acid delta; APACHE II; mortality; SARS-CoV-2; mechanical ventilation.