Publish in this journal
Journal Information
Vol. 46. Issue 3.
Pages 132-139 (March 2022)
Share
Share
Download PDF
More article options
ePub
Visits
...
Vol. 46. Issue 3.
Pages 132-139 (March 2022)
Original article
High serum nitrates levels in non-survivor COVID-19 patients
Altas concentraciones séricas de nitratos en pacientes fallecidos por COVID-19
Visits
...
L. Lorentea,
Corresponding author
lorentemartin@msn.com

Corresponding author.
, F. Gómez-Bernalb, M.M. Martínc, J.A. Navarro-Gonzálvezb, M. Arguesod, A. Pereze, L. Ramos-Gómezf, J. Solé-Violáng, J.A. Marcos y Ramosh, N. Ojedai, A. Jiménezj, Working Group on COVID-19 Canary ICU
a Intensive Care Unit, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
b Laboratory Department, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
c Intensive Care Unit, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
d Intensive Care Unit, Complejo Hospitalario Universitario Insular, Las Palmas de Gran Canaria, Spain
e Internal Intensive Care Unit, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
f Intensive Care Unit, Hospital General La Palma, Breña Alta, Santa Cruz de Tenerife, Spain
g Intensive Care Unit, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain
h Intensive Care Unit, Hospital Doctor José Molina Orosa, Arrecife, Las Palmas, Spain
i Department of Anesthesiology, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain
j Research Unit, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Tables (4)
Table 1. Demographic and clinical data of non-surviving and surviving patients.
Table 2. Laboratory data at ICU admission of non-surviving and surviving patients.
Table 3. Treatment data in ICU of non-surviving and surviving patients.
Table 4. Multiple logistic regression analyses to predict mortality at 30 days.
Show moreShow less
Abstract
Objective

Higher blood nitrate and nitrite levels have been found in coronavirus disease 2019 (COVID-19) patients than in healthy subjects. The present study explores the potential association between serum nitrate levels and mortality in COVID-19 patients.

Design

A prospective observation study was carried out.

Setting

Eight Intensive Care Units (ICUs) from 6 hospitals in the Canary Islands (Spain).

Patients

COVID-19 patients admitted to the ICU.

Interventions

Determination of serum nitrate levels at ICU admission.

Main variable of interest

Mortality at 30 days.

Results

Non-surviving (n=11) compared to surviving patients (n=42) showed higher APACHE-II (p<0.001) and SOFA scores (p=0.004), and higher serum nitrate levels (p=0.001). Logistic regression analyses showed serum nitrate levels to be associated to 30-day mortality after controlling for SOFA (OR=1.021; 95%CI=1.006–1.036; p=0.01) or APACHE-II (OR=1.023; 95%CI=1.006–1.041; p=0.01). There were no differences in the area under the curve (AUC) for mortality prediction by serum nitrate levels (AUC=83%; 95%CI=73–92%; p<0.001), APACHE II (AUC=85%; 95%CI=75–96%; p<0.001) and SOFA (AUC=78%; 95%CI=63–92%; p=0.005) based on the DeLong method. The Kaplan–Meier analysis found patients with serum nitrates levels>68.4μmol/l to have a higher mortality rate (hazard ratio=138.8; 95%CI=22.3–863.9; p<0.001).

Conclusions

The main novel finding was the association between serum nitrate levels and mortality in COVID-19 patients controlling for the SOFA or APACHE-II scores, though larger studies are needed to confirm this observation.

Keywords:
Serum nitrate levels
COVID-19
Patients
Mortality
Prognosis
Resumen
Objetivo

Se han encontrado niveles más elevados de nitratos en la sangre de pacientes con enfermedad del coronavirus 2019 (COVID-19) que en sujetos sanos. Por lo tanto, el objetivo de estudio consistió en explorar la posible asociación entre los niveles séricos de nitratos y la mortalidad de pacientes por COVID-19.

Diseño

Estudio observacional y prospectivo.

Ámbito

Ocho unidades de cuidados intensivos (UCI) de 6 hospitales de las Islas Canarias (España).

Pacientes

Pacientes COVID-19 ingresados en la UCI.

Intervenciones

Se midieron los niveles séricos de nitratos al ingreso en la UCI.

Variable de interés principal

Mortalidad a los 30 días.

Resultados

Los pacientes fallecidos (n=11) comparados con los supervivientes (n=42) presentaron mayores APACHE-II (p<0,001), SOFA (p=0,004) y niveles séricos de nitratos (p=0,001). Los análisis de regresión logística mostraron una asociación entre los niveles séricos de nitratos al ingreso en la UCI y la mortalidad a los 30 días controlando por SOFA (OR:1.021; IC 95%:1.006-1.036; p=0,01) o APACHE-II (OR:1.023; IC 95%:1.006-1.041; p=0,01). No encontramos diferencias en el área bajo la curva (ABC) para la predicción de mortalidad entre los niveles séricos de nitratos (ABC:83%; IC 95%:73-92%; p<0,001), APACHE-II (ABC:85%; IC 95%:75-96%; p<0,001) y SOFA (ABC:78%; IC 95%:63-92%; p=0,005) con el método de DeLong. El análisis de Kaplan-Meier mostró que los pacientes que tenían niveles séricos de nitratos al ingreso en la UCI>68,4μmol/l presentaban mayor riesgo de fallecer (hazard ratio:138,8; IC 95%:22,3-863,9; p<0,001).

Conclusiones

El principal nuevo hallazgo fue la asociación entre los niveles séricos de nitratos y la mortalidad de pacientes COVID-19 controlando por SOFA o APACHE-II; pero estudios de mayor tamaño muestral son necesarios para confirmar este resultado.

Palabras clave:
Niveles séricos de nitratos
COVID-19
Mortalidad
Pronóstico

Article

These are the options to access the full texts of the publication Medicina Intensiva (English Edition)
Member
If you are a member of the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias::
Go to the members area of the website of the SEMICYUC (www.semicyuc.org )and click the link to the magazine.
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Intensiva (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Medicina Intensiva (English Edition)

Subscribe to our newsletter

es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?