Although acute kidney injury (AKI) is common among patients with coronavirus disease 2019 (COVID-19), there are only limited data on its occurrence at intensive care unit (ICU) admission. Assessing the factors associated with AKI is essential for early diagnosis and intervention. This study aims to compare the clinical and laboratory characteristics and survival outcomes of COVİD-19 patients with and without AKI at ICU admission and determine the factors associated with AKI. In this study, patients with SARS-CoV-2 infection were categorized based on the presence (AKI group) or absence (non-AKI group) of AKI. Clinical and laboratory data and outcomes were analyzed retrospectively. Of the 712 patients included in this study, 198 were assigned to the AKI group and 514 were assigned to the non-AKI group. Patients with AKI had more comorbidities and higher disease severity; higher rates of invasive mechanical ventilation, vasopressor therapy, and mortality; and longer hospital stays (p < 0.05). Our multivariate analysis identified advanced age, a high Acute Physiology and Chronic Health Evaluation II score, a high neutrophil-to-lymphocyte ratio, a low albumin level, and the presence of comorbidities as independent factors associated with AKI. In patients with COVID-19, AKI observed at ICU admission is associated with advanced age and increased disease severity. The early diagnosis and monitoring of patients may improve clinical outcomes.

Background: Patients with heart failure (HF) admitted to the intensive care unit (ICU) often require respiratory support, yet comparative data on different respiratory modalities in this population remain limited. The aim of our study was to analyze clinical characteristics and outcomes of HF patients in the ICU receiving various respiratory therapies, while also identifying factors associated with mortality. Methods: This retrospective observational study categorized patients (n = 692) based on their respiratory treatments into four groups: no treatment (T-NR; n = 280); oxygen therapy (T-O₂; n = 220); non-invasive mechanical ventilation (T-NIMV; n = 99); and invasive mechanical ventilation (T-IMV; n = 93). The groups were compared in terms of clinical characteristics, laboratory values at ICU admission and discharge, length of stay, and outcomes. Results: The T-IMV group had significantly higher Acute Physiology and Chronic Health Evaluation II (APACHE II) and updated Charlson Comorbidity Index scores, alongside lower ejection fractions and higher rates of vasopressor/inotrope use (p < 0.05). This group also exhibited higher mortality, longer ICU stays, and more adverse laboratory profiles (elevated lactate, creatinine, N-terminal pro-B-type natriuretic peptide-NT-proBNP, bilirubin; lower albumin). Multivariable analysis confirmed that the APACHE II score, vasopressor/inotrope requirement, and lactate and NT-proBNP levels (at admission) were independently associated with mortality (p < 0.05). Conclusions: Patients requiring IMV demonstrated greater severity of illness, as reflected by higher APACHE II scores, elevated NT-proBNP and lactate levels at admission, as well s increased requirement for vasopressor/inotrope therapy. These variables were associated with mortality, suggesting that the poorer prognosis observed in the IMV group was due to their underlying disease burden.

Chronic obstructive pulmonary disease (COPD) is a recognized risk factor for poor outcomes in SARS-CoV-2 infection, yet its specific impact on critically ill patients remains unclear. We aimed to compare the clinical and laboratory profiles of ICU SARS-CoV-2 pneumonia patients with or without pre-existing COPD and identify factors associated with mortality among those with COPD. In this retrospective study, adult intensive care unit (ICU) admissions for SARS-CoV-2 pneumonia (n = 1536) were divided into a COPD group (n = 253) and a non-pulmonary-disease (NPD) group (n = 1283). Demographics and clinical characteristics, severity of disease, length of stay, laboratory values, and survival outcomes were compared. COPD patients were older, had higher Acute Physiology and Chronic Health Evaluation score, and had a greater prevalence of comorbidities (p < 0.05). They required invasive mechanical ventilation (IMV) more frequently, had experienced higher mortality, and had shorter hospital stays (p < 0.05). Ferritin levels were lower in COPD patients (p < 0.001). Multivariate regression analysis also identified that length of hospital stay, IMV, elevated procalcitonin, and neutrophil-to-lymphocyte ratio (NLR) were associated with COPD patients’ mortality (p < 0.05). COPD is associated with an increased disease burden and mortality rate in critically ill SARS-CoV-2 patients. High NLR levels and IMV are significantly associated with mortality in these patients.

A rapid method for the early diagnosis of fatal mushroom poisoning is not available. Therefore, in our region, symptomatic patients are admitted to intensive care units (ICUs) for close monitoring and treatment. This retrospective study evaluated ICU patients with mushroom poisoning to assess clinical and laboratory trends, treatment characteristics, and outcomes and determine the necessity of level 3 ICU admission. Fifty-four patients were included in this study, and the duration of ICU stay was 5.5 ± 3.9 days. Acute liver failure (ALF) was observed in 7% of patients. Eight patients (14.8%) only received symptomatic treatment, whereas two patients underwent liver transplantation, and one of whom died. The overall mortality rate was 5.6%. A significant decrease was observed in alanine aminotransferase, aspartate aminotransferase, bilirubin, urea, creatinine, lactate dehydrogenase, international normalized ratio, and prothrombin time values on the day of discharge from the ICU compared with the day of admission (p < 0.05). Mushroom poisoning cases thought to be at risk of developing ALF can be transferred to transplant centers early to avoid wasting time. However, to ensure that ICU resources are used effectively, we believe that monitoring and treatment in a level 3 ICU should be reserved for patients progressing to liver failure rather than all symptomatic patients.