Consequences of COVID-19 on the respiratory, coagulation, immune and endocrine system and association with bacterial infections among patients treated in the intensive care unit.

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Assessment of the impact of SARS-CoV-2 infection on the respiratory, coagulation, immune and endocrine system and the frequency of bacterial infections in patients hospitalized in the intensive care unit. This is a retrospective and cross-sectional study among patients who were treated in ICU for COVID-19. Clinical records and medical documentation obtained during hospitalization of patients in the Department of Anaesthesiology and Intensive Care in the 4th Military Clinical Hospital in Wroclaw in the period from June 1st, 2021 to July 31st, 2021 due to COVID-19 will be evaluated. Apart from the assessment of Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation II (APACHE II), and Simplified Acute Physiology Score II (SAPS II) scales, the selected parameters of the coagulation, hematopoietic, endocrine systems as well as inflammatory and renal parameters will be analyzed. These examinations were taken routinely every day. Ventilation parameters and modes according to the type of ARDS (type H or L) and the effectiveness of the prone position was evaluated. In addition, the study is designed to assess the incidence of bacterial infections, particularly with multi-drug resistant strains, and fungal infections. Medications administered and the incidence of thromboembolic complications were recorded. Additionally, demographic data, BMI, blood group, and the presence of co-morbidities and actual medications will be studied. Symptomatic respiratory distress in COVID-19 often leads to the development of acute respiratory distress syndrome (ARDS) and the need for mechanical ventilation. In addition, bacterial superinfection occurs in patients with immunological disorders and in the course of steroid therapy. Increasingly, co-infections with multidrug-resistant strains are observed, which further worsen prognosis. Thus, patients infected with SARS-CoV-2 have an excessive susceptibility to activation of the coagulation system, hypertension, insulin resistance, alveolar edema, and ARDS. We would like to ensure that participants received interventions regardless of their involvement in the study.