Impact of COVID status and blood group on complications in patients in hemorrhagic shock.

Autor:	Brill JB; Department of Surgery, McGovern Medical School at University of Texas Health Science Center at Houston, Houston, Texas, USA., Mueck KM; Department of Surgery, McGovern Medical School at University of Texas Health Science Center at Houston, Houston, Texas, USA., Cotton ME; Department of Surgery, McGovern Medical School at University of Texas Health Science Center at Houston, Houston, Texas, USA., Tang B; Department of Surgery, McGovern Medical School at University of Texas Health Science Center at Houston, Houston, Texas, USA., Sandoval M; Department of Surgery, McGovern Medical School at University of Texas Health Science Center at Houston, Houston, Texas, USA., Kao LS; Department of Surgery, McGovern Medical School at University of Texas Health Science Center at Houston, Houston, Texas, USA., Cotton BA; Department of Surgery, McGovern Medical School at University of Texas Health Science Center at Houston, Houston, Texas, USA.
Jazyk:	angličtina
Zdroj:	Trauma surgery & acute care open [Trauma Surg Acute Care Open] 2024 Mar 22; Vol. 9 (1), pp. e001250. Date of Electronic Publication: 2024 Mar 22 (Print Publication: 2024).
DOI:	10.1136/tsaco-2023-001250
Abstrakt:	Objective: Among critically injured patients of various blood groups, we sought to compare survival and complication rates between COVID-19-positive and COVID-19-negative cohorts. Background: SARS-CoV-2 infections have been shown to cause endothelial injury and dysfunctional coagulation. We hypothesized that, among patients with trauma in hemorrhagic shock, COVID-19-positive status would be associated with increased mortality and inpatient complications. As a secondary hypothesis, we suspected group O patients with COVID-19 would experience fewer complications than non-group O patients with COVID-19. Methods: We evaluated all trauma patients admitted 4/2020-7/2020. Patients 16 years or older were included if they presented in hemorrhagic shock and received emergency release blood products. Patients were dichotomized by COVID-19 testing and then divided by blood groups. Results: 3281 patients with trauma were evaluated, and 417 met criteria for analysis. Seven percent (29) of patients were COVID-19 positive; 388 were COVID-19 negative. COVID-19-positive patients experienced higher complication rates than the COVID-19-negative cohort, including acute kidney injury, pneumonia, sepsis, venous thromboembolism, and systemic inflammatory response syndrome. Univariate analysis by blood groups demonstrated that survival for COVID-19-positive group O patients was similar to that of COVID-19-negative patients (79 vs 78%). However, COVID-19-positive non-group O patients had a significantly lower survival (38%). Controlling for age, sex and Injury Severity Score, COVID-19-positive patients had a greater than 70% decreased odds of survival (OR 0.28, 95% CI 0.09 to 0.81; p=0.019). Conclusions: COVID-19 status is associated with increased major complications and 70% decreased odds of survival in this group of patients with trauma. However, among patients with COVID-19, blood group O was associated with twofold increased survival over other blood groups. This survival rate was similar to that of patients without COVID-19. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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