(722) National Trends in Critical Illness Polyneuropathy & Myopathy in COVID ARDS on Invasive Ventilation

Monday, February 24, 2025

2:30pm – 3:30pm Eastern Time

Location: Connections Central - RST 17

First Author(s)

Antony Arumairaj, MD

New York City Health and Hospitals Coporation.
New York Medical College
New York, New York, United States

Co-Author(s)

JM

Joseph Mattana, MD

Department Chair
New York Medical College, NYC Health and Hospitals/Metropolitan.
New York, New York, United States
SC

Shobhana Chaudhari, MD

Program director
New York Medical College, NYC Health and Hospitals/Metropolitan.
New York, New York, United States
IH

Imnett Habtes, MD

Attending Physician
New York Medical College, NYC Health and Hospitals/Metropolitan.
New York, New York, United States

Introduction: Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are neuromuscular complications encountered in patients with COVID associated ARDS who are on invasive ventilation. This National Inpatient Sample (NIS) study aimed to determine the clinical and mortality outcomes of CIP and CIM in patients with COVID ARDS on invasive ventilation.

Methods: We identified patients hospitalized with COVID-19 infection and CIP and CIM from the 2020-2021 NIS database. STATA/MP 17.0 software was used for statistical analysis. Multivariate logistic regression analysis was performed.

Results: 818,011 patients were hospitalized with COVID-19 infection, 39,401 patients underwent invasive ventilation for COVID ARDS and 20,784 patients had complications of CIP and CIM. The patients with CIP and CIM were stratified based on the status of COVID ARDS on invasive ventilation. There were 18,205 patients with CIP and CIM without COVID ARDS on invasive ventilation and 2,579 patients with CIP and CIM from COVID ARDS on invasive ventilation. Caucasians and patients in the lowest national income constituted the largest ethnic group and largest group among the ethnic and national income categories, respectively, in both groups. The mortality rate among patients with CIP and CIM from COVID ARDS on invasive ventilation was 22.5%; for those without COVID ARDS on invasive ventilation, it was 9.5%, with a P value of < 0.001. The length of hospital stay among patients with CIP and CIM from COVID ARDS on invasive ventilation was 41 days; for those without COVID ARDS on invasive ventilation, it was 22.5 days, with a P value of < 0.001. The unadjusted (odds ratio) OR of mortality among patients with CIP and CIM from COVID ARDS on invasive ventilation was 2.77 and adjusted OR of mortality after adjustment for age, sex, race, Charlson comorbid index, national income quartile, and insurance was 3.28 with a P-value of < 0.001, thereby indicating that the mortality rate among patients with CIP and CIM from COVID ARDS on invasive ventilation was more than 3 times higher than those without COVID ARDS on invasive ventilation.

Conclusions: Our analysis of the NIS database suggests that patients with COVID ARDS on invasive ventilation resulted in more severe outcomes of CIP and CIM with a longer stay and higher mortality rate.