​Ocena in vpliv dejavnikov tveganja na izid zdravljenja starejših bolnikov s kritično obliko SARS-CoV-2 okužbe​

Kurnik, Marko (author), Podbregar, Matej (mentor)

Doktorska disertacija obravnava ključne prognostične dejavnike, ki vplivajo na kratkoročno in dolgoročno preživetje starejših kritično bolnih bolnikov s hudo pljučnico, povzročeno z virusom SARS-CoV-2. V treh retrospektivnih opazovalnih raziskavah, ki so vključevale bolnike, stare 70 let ali več, sprejete v namensko enoto intenzivne terapije, je bila ocenjena prognostična vrednost obposteljnih ehokardiografskih parametrov in indeksa telesne mase (ITM). Povišan sistolični tlak v pljučni arteriji (sPAP) ob sprejemu se je izkazal kot močan in neodvisen napovedovalec umrljivosti v EIT, bolnišnici in dolgoročnem spremljanju, kar poudarja osrednjo vlogo akutne prizadetosti pljučnega žilja pri slabem izidu bolezni. Nasprotno pa je bil višji ITM (≥30 kg/m²) povezan z boljšim preživetjem, kar potrjuje obstoj paradoksa debelosti pri tej populaciji. Rezultati poudarjajo pomen zgodnje, neinvazivne obposteljne ocene hemodinamike in prehranskega statusa za stratifikacijo tveganja in individualizirano obravnavo starejših bolnikov s kritično obliko COVID-19.

• Language: Slovenian
• Keywords: COVID-19, starejši, kratkoročna umrljivost, dolgoročna umrljivost, ehokardiografija, ultrazvok pljuč, sistolični tlak v pljučni arteriji, pljučna hipertenzija, sPAP, PASP, indeks telesne mase, debelost, intenzivna terapija, EIT
• Work type: Doctoral dissertation
• Organization: MF - Faculty of Medicine
• Year: 2026
• PID: 20.500.12556/RUL-182811
• Publication date in RUL: 24.05.2026

Secondary language

• Language: English
• Title: Assessment and impact of risk factors on the outcome of treatment of elderly patients with a critical form of SARS-CoV-2 infection​​

Abstract

This doctoral thesis evaluates key prognostic factors influencing short- and long-term outcomes in elderly critically ill patients with severe SARS-CoV-2 pneumonia. In three retrospective observational studies including patients aged ≥70 years admitted to a dedicated intensive care unit, the prognostic value of bedside echocardiographic parameters and body mass index (BMI) was assessed. Elevated systolic pulmonary artery pressure (sPAP) at ICU admission emerged as a strong and independent predictor of ICU, hospital, and long-term mortality, reflecting acute pulmonary vascular involvement as a central pathophysiological mechanism of poor outcome. In contrast, higher BMI (≥30 kg/m²) was associated with significantly improved survival, confirming the presence of an obesity paradox in this population. These findings highlight the clinical value of early, non-invasive bedside assessment of pulmonary hemodynamics and nutritional status for risk stratification and individualized management of elderly patients with critical COVID-19.

• Keywords: COVID-19, elderly, short-term mortality, long-term mortality, echocardiography, lung ultrasound, pulmonary artery systolic pressure, pulmonary hypertension, sPAP, PASP, body mass index, obesity, intensive care unit, ICU