Optic nerve sheath diameter, intensive care unit admission and COVID-19-related-in-hospital mortality.

Background Hypoxia and hypercapnia due to acute pulmonary failure in patients with coronavirus disease 2019 (COVID-19) can increase the intracranial pressure (ICP). ICP correlated with the optic nerve sheath diameter (ONSD) on ultrasonography and is associated with a poor prognosis. Aim We investigated the capability of ONSD measured during admission to the intensive care unit (ICU) in patients with critical COVID-19 in predicting in-hospital mortality. Methods A total of 91 patients enrolled in the study were divided into two groups: survivor (n  = 48) and nonsurvivor (n  = 43) groups. ONSD was measured by ultrasonography within the first 3 h of ICU admission. Results The median ONSD was higher in the nonsurvivor group than in the survivor group (5.95 mm vs. 4.15 mm, P  <   0.001). The multivariate Cox proportional hazard regression analysis between ONSD and in-hospital mortality (contains 26 covariates) was significant (adjusted hazard ratio, 4.12; 95% confidence interval, 1.46–11.55; P  =   0.007). The ONSD cutoff for predicting mortality during ICU admission was 5 mm (area under the curve, 0.985; sensitivity, 98%; and specificity, 90%). The median survival of patients with ONSD >5 mm (43%; n  = 39) was lower than those with ONSD ≤5 mm (57%; n  = 52) (11.5 days vs. 13.2 days; log-rank test P  =   0.001). Conclusions ONSD ultrasonography during ICU admission may be an important, cheap and easy-to-apply method that can be used to predict mortality in the early period in patients with critical COVID-19. [ABSTRACT FROM AUTHOR]