Dexmedetomidine May Delay Intubation in Patients With Severe COVID-19

Abstract

Aim/Objective: Dexmedetomidine (DEX), a highly selective α2-adrenoceptor agonist, has sedative, analgesic, anxiolytic, and immunomodulatory properties that may provide benefits in critically ill patients with COVID-19. This study aimed to evaluate the effect of DEX on clinical outcomes in patients with severe COVID-19 treated in the intensive care unit (ICU). Methods: We retrospectively analyzed the medical records of patients admitted to the ICUs of Sakarya University Training and Research Hospital with a diagnosis of COVID-19 between October 2020 and February 2021. A total of 134 patients were included, of whom 45 received DEX and 89 did not. DEX infusion was discontinued upon intubation. Patients receiving DEX in addition to standard care were classified as the DEX group, while those receiving other sedatives or no sedative treatment were classified as the non-DEX group. Demographic, clinical, laboratory, and outcome data were compared between groups. Results: The median age of the study population was 64 years, and 62.7% were male. Age distributions were similar between groups (p>0.05). Patients with diabetes mellitus and those receiving insulin therapy were less likely to receive DEX (p=0.040 and p=0.016, respectively). The median time from ICU admission to intubation was significantly longer in the DEX group than in the non-DEX group (4 vs. 1 day, p<0.001). No significant differences were observed between groups regarding laboratory findings, mortality, intubation rates, comorbidities, or other treatments.