@NurseGoodVol I know you changed jobs, but i remember you posting info about commonalities of people in the hospital with Covid. Are there any updated numbers?
I remember vitamin D and overweight being two of the more common links. I was wondering if that still stoodup, or with more data if other/better trends have emerged?
@kiddiedoc I will loop you into this request as well.
I’m sorry Louder, busy week.
Most of my pts were ventilated, sedated, medicated for pain and paralyzed. So I’m speaking from that microcosm that is icu and critical care.
The patients that faired the worst, I’m talking about 50% mortality or worse were 2 out of 3 for hypertension, diabetes and morbid obesity, recently remission cancer pts, recent runs of chemo, testing positive for longer than 30 days, those that weren’t anticoagulated, those that were kept at net negative fluid balance and those that had restrictive lung disease. If they had a combination of several of these mortality rose sharply. We could not ventilated these pts so we put them on their stomachs if they tolerated it.
Vitamin D was an issue and many of my pts nutritional panels were horrible coming in. We fed them per weight based caloric needs with tube feedings but with them being sedated and paralyzed their gut was not optimal for motility and absorption. We had many pts develop ileus. ( the gut stops moving which is always bad) Their nutritional panels didn’t get much worse but they didn’t get better. Vitamins and minerals for support of the immune system were not emphasized even when challenged on the subject.
When I was not doing critical care obesity and hypertension played a big roll. The pts required high O2 support like I’ve never seen before. Their lungs were acting like CO2 and O2 exchange were a foreign concept to them. I was thankful for every one we didn’t have to vent.
Keep in mind many of my pts were critically ill coming in. Their livers and kidneys had taken a hit from a low flow state and they had several systems compromised all at the same time. Their outlook was very bleak.
There were of course medical mistakes made specifically not anticoagulating pts that still, obviously, chaps my ass today. Providers couldn’t think independently at the clotting we were seeing because the cdc said don’t anticoagulant them. Lesson learned, the cdc does not always know what they are talking about.
That last paragraph was my own opinion, one I strongly believe in.