Investigating the Effect of Expiratory Time Constant on Outcome in Intubated Patients with Acute Respiratory Failure Caused by COVID-19 in Critical Care Unit: A Research Study

Clinical manifestations of pain in patients suffering from COVID-19 infected with Delta variant of SARS-Cov-2

Background

Although respiratory presentations of COVID-19 predominate, the extra pulmonary involvement such as muscle pain, joint pain, headache, back pain, abdominal pain, and sore throat are usually included in the clinical picture of the disease and it can be considered as an early symptom in COVID-19 patients. The objective of the present study was to determine the frequency, localization, and intensity of pain in COVID-19 patients hospitalized in Imam Khomeini hospital of Ardabil, Iran.

Methods and materials

A prospective study was conducted on 388 COVID-19 patients who were admitted to Ardabil, Iran's Imam Khomeini Central Hospital between March and June 2020. Demographic characteristics of patients and general clinical manifestations of pain at the first admission to the hospital, localization, severity, and continuity of pain were evaluated by using a questionnaire and the Visual Analog Scale (VAS).

Findings

For the 388 (51.3% female, age 47.25 + 15.55 and 48.7% male, age 50.12 + 15.26 years old) Delta COVID-19 patients, the median duration from illness onset to hospitalization was 5 days. Patients' complaints included 89.7% fatigue, 85.56% cough, 67.8% fever, 64.17% loss of taste, 63.91% loss of smell, 37.9% diarrhea, and 11.85% skin lesions, respectively. Pain including muscle, joint, bone and low back pain was the chief complaint in both sexes. Pain complaints had started on average 5 days before admission. The distribution of pain was 313 (80.41%) muscle pain, 264 (70.61%) joint pain, 299 (77.1%) headache, 208 (53.6%) low back pain, 312 (80.41%) sore throat, and 157 (40.46%) abdominal pain. Out of 388 patients, 292 (75.25%) had diffuse pain.

Conclusions

Acute pain including myalgia, sore throat, arthralgia, headache, and low back pain were the most common symptoms of COVID-19 patients. Viral diseases such as COVID-19 may trigger the immune system to release cytokines that lead to muscle pain. Patients presenting to healthcare centers with complaints of pain should be evaluated for suspected COVID-19 infection.

Evaluating the Efficacy of the National Early Warning Score in Predicting the Mortality of Stroke Patients Admitted to Intensive Care Units

Background

National Early Warning Score (NEWS) is a tool used to identify patients at risk. Scores are based on initial clinical observations, including heart rate, respiration rate, systolic blood pressure, oxygen saturation, level of consciousness, body temperature, and oxygen support. To date, few studies have been conducted on NEWS evaluation worldwide, and no study has been conducted in Iran.

Objectives

This study aims to evaluate the efficacy of the NEWS in predicting the mortality of stroke patients admitted to intensive care units (ICU).

Methods

The present cross-sectional study included 90 patients with a definitive diagnosis of cerebrovascular accident (CVA) based on symptoms and para-clinical evidence. At the beginning of admission to the ICU and up to first 24 hours of admission, all NEWS parameters were measured and evaluated.

Results

There was a significant relationship between systolic blood pressure, respiratory support, heart rate, and level of consciousness with patients’ discharge status. Also, there was no significant relationship between age, sex, respiratory rate, SPO2, and fever with discharge status. In addition, there was a significant relationship between clinical risk based on NEWS scoring system and patients’ status.

Conclusions

Our results showed a significant relationship between clinical risk based on NEWS scoring and patients’ discharge status so that there was a significant increase in mortality in patients with higher NEWS.