P11‐6: Indices of endogenous intoxication in patients with COVID‐19 associated pneumonia

Background and Aims : One of the most emerging issues among sepsis survivors is new onset cardiovascular disease. It is postulated that inflammatory response and endothelial dysfunction can persist beyond acute infection and hospitalisation, hence incurring long-term cardiovascular risks. We aim to describe the incidence of delayed cardiovascular events (CVE) among sepsis survivors, its risk factors and impact on mortality. Methods : This was a single centre retrospective cohort study of sepsis patients admitted to medical ICU between July 2015 to October 2016 who were survived hospitalisation, and followed-up for one year from time of ICU admission. Primary outcome was incident CVE that occurred after hospital dis-charge. Secondary outcome was one-year all-cause mortality. Results : There were 359 sepsis survivors. 235 (65.5%) were males. Median (interquartile range, IQR) age was 67 (55-76) years old. 64 (17.8%) had one or more CVE: 5 (1.4%) acute coronary syndromes; 16 (4.5%) type 2 myocardial infarction; 10 (2.8%) coronary angiogram/revascularisation; 10 (2.8%) incident atrial fibrillation; 26 (7.2%) new or worsening heart failure; 6 (1.7%) cerebrovascular accident and 10 (2.8%) cardiovascular deaths. Factors associated with CVE in univari-ate analysis are diabetes, hypertension, hyperlipidemia, pre-existing cardiovascular disease (ischemic heart disease, heart failure, valvular heart disease and peripheral vascular dis-ease), chronic kidney disease and anemia (hemoglobin <9g/ dL). Sepsis survivors with CVE had higher one-year all-cause mortality times less likely to be discharged (OR = -111.00, p = 0.01) than those who were not intubated. The mean duration of high-flow nasal cannula therapy was also significantly higher among females ( β = 0.36, p = 0.007) and the mean duration of hospital stay was higher ( β = 0.29, p = 0.032) among those with existing respiratory comorbidities. Conclusion : High-flow nasal cannula therapy is a viable oxygenation supplementation approach with better clinical outcomes among hypoxemic, COVID-19 confirmed adult patients rather than invasive and aggressive oxygen therapy. Nonetheless, further empirical evidence is warranted to develop clinical practice guidelines on the use of high-flow nasal cannula among hypoxemic, COVID-19 confirmed adult patients. index (LIIm), the integral index of intoxication (IPI), the neutrophil-to-monocyte ratio index (ISNM), the neutrophil-to-lymphocyte ratio index (ISNL). The difference in indicators was considered statistically significant at p<0.05. This study was performed in accordance with the Declaration of Helsinki. This human study was approved by Ethics Commit-tee of Amur State Medical Academy. Results and Conclusions : In group 2, LIIm was 17.3% higher than in group 1. In group 2, an increase in the integral index of intoxication (III) by 17.8% (p<0.02) was detected. It may indicate respiratory disorders associated with EI. Group 2 patients showed a 13.6% increase in NMRI (p<0.031), as well as an 18.1% increase in NLRI (p<0.02) compared to group 1. The results obtained indicate more pronounced EI hemato-logical symptoms, as well as the presence of associated respiratory disorders in patients with severe pneumonia caused by COVID-19.