Journal of Epidemiology and Global Health

Volume 11, Issue 1, March 2021, Pages 98 - 104

Clinical Characteristics and Predictors of 28-Day Mortality in 352 Critically Ill Patients with COVID-19: A Retrospective Study

Authors
Abdulrahman Alharthy1, Waleed Aletreby1, ORCID, Fahad Faqihi1, Abdullah Balhamar1, Feisal Alaklobi2, Khaled Alanezi1, Parameaswari Jaganathan3, ORCID, Hani Tamim4, Saleh A Alqahtani5, 6, ORCID, Dimitrios Karakitsos1, 7, ORCID, Ziad A Memish3, 8, 9, *
1Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia
2Pediatrics Department, King Saud Medical City, Riyadh, Saudi Arabia
3Research & Innovation Centre King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
4Biostatistics Unit, Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
5Liver Transplantation Unit, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
6Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, USA
7University of South Carolina, School of Medicine, Columbia, SC, USA
8College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
9Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
*Corresponding author. Email: zmemish@yahoo.com
Corresponding Author
Ziad A Memish
Received 4 September 2020, Accepted 19 September 2020, Available Online 3 October 2020.
DOI
https://doi.org/10.2991/jegh.k.200928.001How to use a DOI?
Keywords
COVID-19, intensive care unit, mortality, active smoking, pulmonary embolism, d-dimers, lactate
Abstract

Background: Since the first COVID-19 patient in Saudi Arabia (March, 2020) more than 338,539 cases and approximately 4996 dead were reported. We present the main characteristics and outcomes of critically ill COVID-19 patients that were admitted in the largest Ministry of Health Intensive Care Unit (ICU) in Saudi Arabia.

Methods: This retrospective study, analyzed routine epidemiologic, clinical, and laboratory data of COVID-19 critically ill patients in King Saud Medical City (KSMC), Riyadh, Saudi Arabia, between March 20, 2020 and May 31, 2020. Severe acute respiratory syndrome coronavirus-2 infection was confirmed by real-time reverse transcriptase polymerase chain reaction assays performed on nasopharyngeal swabs in all enrolled cases. Outcome measures such as 28-days mortality, duration of mechanical ventilation, and ICU length of stay were analyzed.

Results: Three-hundred-and-fifty-two critically ill COVID-19 patients were included in the study. Patients had a mean age of 50.63 ± 13.3 years, 87.2% were males, and 49.4% were active smokers. Upon ICU admission, 56.8% of patients were mechanically ventilated with peripheral oxygen saturation/fraction of inspired oxygen (SpO2/FiO2) ratio of 158 ± 32. No co-infections with other endemic viruses were observed. Duration of mechanical ventilation was 16 (IQR: 8–28) days; ICU length of stay was 18 (IQR: 9–29) days, and 28-day mortality was 32.1%. Multivariate regression analysis showed that old age [Odds Ratio (OR): 1.15, 95% Confidence Intervals (CI): 1.03–1.21], active smoking [OR: 3, 95% CI: 2.51–3.66], pulmonary embolism [OR: 2.91, 95% CI: 2.65–3.36), decreased SpO2/FiO2 ratio [OR: 0.94, 95% CI: 0.91–0.97], and increased lactate [OR: 3.9, 95% CI: 2.4–4.9], and d-dimers [OR: 2.54, 95% CI: 1.57–3.12] were mortality predictors.

Conclusion: Old age, active smoking, pulmonary embolism, decreased SpO2/FiO2 ratio, and increased lactate and d-dimers were predictors of 28-day mortality in critically ill COVID-19 patients.

Copyright
© 2020 The Authors. Published by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Download article (PDF)
View full text (HTML)

Journal
Journal of Epidemiology and Global Health
Volume-Issue
11 - 1
Pages
98 - 104
Publication Date
2020/10
ISSN (Online)
2210-6014
ISSN (Print)
2210-6006
DOI
https://doi.org/10.2991/jegh.k.200928.001How to use a DOI?
Copyright
© 2020 The Authors. Published by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

TY  - JOUR
AU  - Abdulrahman Alharthy
AU  - Waleed Aletreby
AU  - Fahad Faqihi
AU  - Abdullah Balhamar
AU  - Feisal Alaklobi
AU  - Khaled Alanezi
AU  - Parameaswari Jaganathan
AU  - Hani Tamim
AU  - Saleh A Alqahtani
AU  - Dimitrios Karakitsos
AU  - Ziad A Memish
PY  - 2020
DA  - 2020/10
TI  - Clinical Characteristics and Predictors of 28-Day Mortality in 352 Critically Ill Patients with COVID-19: A Retrospective Study
JO  - Journal of Epidemiology and Global Health
SP  - 98
EP  - 104
VL  - 11
IS  - 1
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.200928.001
DO  - https://doi.org/10.2991/jegh.k.200928.001
ID  - Alharthy2020
ER  -