tetano
Editor, Senior Moderator
J Clin Med
. 2022 May 5;11(9):2592.
doi: 10.3390/jcm11092592.
Epidemiology, Clinical Presentation and Treatment of Non-Hepatic Hyperammonemia in ICU COVID-19 Patients
Nardi Tetaj[SUP] 1 [/SUP], Giulia Valeria Stazi[SUP] 1 [/SUP], Maria Cristina Marini[SUP] 1 [/SUP], Gabriele Garotto[SUP] 1 [/SUP], Donatella Busso[SUP] 1 [/SUP], Silvana Scarcia[SUP] 1 [/SUP], Ilaria Caravella[SUP] 1 [/SUP], Manuela Macchione[SUP] 1 [/SUP], Giada De Angelis[SUP] 1 [/SUP], Rachele Di Lorenzo[SUP] 1 [/SUP], Alessandro Carucci[SUP] 1 [/SUP], Alessandro Capone[SUP] 2 [/SUP], Andrea Antinori[SUP] 2 [/SUP], Fabrizio Palmieri[SUP] 2 [/SUP], Gianpiero D'Offizi[SUP] 2 [/SUP], Fabrizio Taglietti[SUP] 2 [/SUP], Stefania Ianniello[SUP] 2 [/SUP], Paolo Campioni[SUP] 2 [/SUP], Francesco Vaia[SUP] 3 [/SUP], Emanuele Nicastri[SUP] 2 [/SUP], Enrico Girardi[SUP] 4 [/SUP], Luisa Marchioni[SUP] 1 [/SUP], On Behalf Of Icu Covid-Study Group
Affiliations
Abstract
(1) Background: Although COVID-19 is largely a respiratory disease, it is actually a systemic disease that has a wide range of effects that are not yet fully known. The aim of this study was to determine the incidence, predictors and outcome of non-hepatic hyperammonemia (NHH) in COVID-19 in intensive care unit (ICU); (2) Methods: This is a 3-month prospective observational study in a third-level COVID-19 hospital. The authors collected demographic, clinical, severity score and outcome data. Logistic regression analyses were performed to identify predictors of NHH; (3) Results: 156 COVID-19 patients were admitted to the ICU. The incidence of NHH was 12.2% (19 patients). The univariate analysis showed that invasive mechanical ventilation had a 6.6-fold higher risk (OR 6.66, 95% CI 0.86-51.6, p = 0.039) for NHH, while in the multiple regression analysis, there was a 7-fold higher risk for NHH-but it was not statistically significant (OR 7.1, 95% CI 0.90-56.4, p = 0.062). Demographics, clinical characteristics and mortality in the ICU at 28 days did not show a significant association with NHH. (4) Conclusions: The incidence of NHH in ICU COVID-19 patients was not low. NHH did not appear to significantly increase mortality, and all patients with non-hepatic hyperammonemia were successfully treated without further complications. However, the pathogenesis of NHH in ICU patients with COVID-19 remains a topic to be explored with further research.
Keywords: COVID-19; Coronavirus disease; intensive care unit; non-hepatic hyperammonemia.
. 2022 May 5;11(9):2592.
doi: 10.3390/jcm11092592.
Epidemiology, Clinical Presentation and Treatment of Non-Hepatic Hyperammonemia in ICU COVID-19 Patients
Nardi Tetaj[SUP] 1 [/SUP], Giulia Valeria Stazi[SUP] 1 [/SUP], Maria Cristina Marini[SUP] 1 [/SUP], Gabriele Garotto[SUP] 1 [/SUP], Donatella Busso[SUP] 1 [/SUP], Silvana Scarcia[SUP] 1 [/SUP], Ilaria Caravella[SUP] 1 [/SUP], Manuela Macchione[SUP] 1 [/SUP], Giada De Angelis[SUP] 1 [/SUP], Rachele Di Lorenzo[SUP] 1 [/SUP], Alessandro Carucci[SUP] 1 [/SUP], Alessandro Capone[SUP] 2 [/SUP], Andrea Antinori[SUP] 2 [/SUP], Fabrizio Palmieri[SUP] 2 [/SUP], Gianpiero D'Offizi[SUP] 2 [/SUP], Fabrizio Taglietti[SUP] 2 [/SUP], Stefania Ianniello[SUP] 2 [/SUP], Paolo Campioni[SUP] 2 [/SUP], Francesco Vaia[SUP] 3 [/SUP], Emanuele Nicastri[SUP] 2 [/SUP], Enrico Girardi[SUP] 4 [/SUP], Luisa Marchioni[SUP] 1 [/SUP], On Behalf Of Icu Covid-Study Group
Affiliations
- PMID: 35566715
- DOI: 10.3390/jcm11092592
Abstract
(1) Background: Although COVID-19 is largely a respiratory disease, it is actually a systemic disease that has a wide range of effects that are not yet fully known. The aim of this study was to determine the incidence, predictors and outcome of non-hepatic hyperammonemia (NHH) in COVID-19 in intensive care unit (ICU); (2) Methods: This is a 3-month prospective observational study in a third-level COVID-19 hospital. The authors collected demographic, clinical, severity score and outcome data. Logistic regression analyses were performed to identify predictors of NHH; (3) Results: 156 COVID-19 patients were admitted to the ICU. The incidence of NHH was 12.2% (19 patients). The univariate analysis showed that invasive mechanical ventilation had a 6.6-fold higher risk (OR 6.66, 95% CI 0.86-51.6, p = 0.039) for NHH, while in the multiple regression analysis, there was a 7-fold higher risk for NHH-but it was not statistically significant (OR 7.1, 95% CI 0.90-56.4, p = 0.062). Demographics, clinical characteristics and mortality in the ICU at 28 days did not show a significant association with NHH. (4) Conclusions: The incidence of NHH in ICU COVID-19 patients was not low. NHH did not appear to significantly increase mortality, and all patients with non-hepatic hyperammonemia were successfully treated without further complications. However, the pathogenesis of NHH in ICU patients with COVID-19 remains a topic to be explored with further research.
Keywords: COVID-19; Coronavirus disease; intensive care unit; non-hepatic hyperammonemia.