{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:57:01Z","timestamp":1781067421922,"version":"3.54.1"},"reference-count":33,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T00:00:00Z","timestamp":1705536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Fluid status (FS) is a diagnostic challenge in critically ill patients with COVID-19. Here, we compared parameters related to FS derived from cumulative fluid balance (CFB), bioelectrical impedance analysis (BIA) and venous congestion assessed by ultrasound (VExUS) to predict mortality. We retrospectively reviewed the medical records of individuals with severe pneumonia due to COVID-19 between July and November 2021 in a single center. Comorbidities, demographic, clinical and laboratory data as well as results from CFB, BIA and VExUS measurements were collected on admission and weekly afterwards for two consecutive evaluations. Seventy-nine patients were included, of which eighteen (14.2%) died. Abnormalities of FS were only identified by BIA. Extracellular water\/total body water ratio (ECW\/TBW) &gt; 0.394 (overhydrated) by BIA was a good predictor of mortality (AUC = 0.78, 95% CI: 0.067\u20130.89). Mortality risk was higher in overhydrated patients (OR: 6.2, 95% CI: 1.2\u201332.6, p = 0.02) and in persistently overhydrated patients (OR: 9.57, 95% CI: 1.18\u201377.5, p = 0.03) even after adjustment to age, serum albumin and acute kidney injury (AKI) in stages 2\u20133. Time to death was shorter in overhydrated patients (HR: 2.82, 95% CI: 1.05\u20137.5, log-rank test p = 0.03). Abnormalities in FS associated with mortality were only identified by BIA in critically ill patients with COVID-19.<\/jats:p>","DOI":"10.3390\/jcm13020540","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T03:50:56Z","timestamp":1705549856000},"page":"540","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Fluid Status Assessment in Critically Ill Patients with COVID-19: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5563-0937","authenticated-orcid":false,"given":"Nadia","family":"Rodr\u00edguez-Moguel","sequence":"first","affiliation":[{"name":"Departamento de Investigaci\u00f3n en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias \u201cIsmael Cos\u00edo Villegas\u201d, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3490-3414","authenticated-orcid":false,"given":"Ivan Armando","family":"Osuna-Padilla","sequence":"additional","affiliation":[{"name":"Departamento de \u00c1reas Cr\u00edticas, Instituto Nacional de Enfermedades Respiratorias \u201cIsmael Cos\u00edo Villegas\u201d, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina Bozena","family":"Piekarska","sequence":"additional","affiliation":[{"name":"Departamento de Ense\u00f1anza, Instituto Nacional de Enfermedades Respiratorias \u201cIsmael Cos\u00edo Villegas\u201d, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda-Fernanda","family":"Negrete-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Departamento de Ense\u00f1anza, Instituto Nacional de Enfermedades Respiratorias \u201cIsmael Cos\u00edo Villegas\u201d, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Hern\u00e1ndez-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Facultad de Nutrici\u00f3n, Universidad Aut\u00f3noma del Estado de Morelos, Cuernavaca 62209, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9153-5557","authenticated-orcid":false,"given":"Juli\u00e1n Andr\u00e9s","family":"Contreras-Mar\u00edn","sequence":"additional","affiliation":[{"name":"Departamento de Ense\u00f1anza, Instituto Nacional de Enfermedades Respiratorias \u201cIsmael Cos\u00edo Villegas\u201d, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Monta\u00f1o-Mattar","sequence":"additional","affiliation":[{"name":"Departamento de Ense\u00f1anza, Instituto Nacional de Enfermedades Respiratorias \u201cIsmael Cos\u00edo Villegas\u201d, Mexico City 14080, Mexico"},{"name":"Facultad de Nutrici\u00f3n, Universidad Aut\u00f3noma del Estado de Morelos, Cuernavaca 62209, Mexico"},{"name":"Departamento de Nefrolog\u00eda, Instituto Nacional de Enfermedades Respiratorias \u201cIsmael Cos\u00edo Villegas\u201d, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Casas-Aparicio","sequence":"additional","affiliation":[{"name":"Departamento de Nefrolog\u00eda, Instituto Nacional de Enfermedades Respiratorias \u201cIsmael Cos\u00edo Villegas\u201d, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1080\/08998280.2020.1754700","article-title":"SARS-CoV-2 (COVID-19) and intravascular volume management strategies in the critically ill","volume":"33","author":"Kazory","year":"2020","journal-title":"Bayl. 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