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

Authors

Abdulrahman Alharthy¹, Waleed Aletreby^1, , Fahad Faqihi¹, Abdullah Balhamar¹, Feisal Alaklobi², Khaled Alanezi¹, Parameaswari Jaganathan^3, , Hani Tamim⁴, Saleh A Alqahtani^{5, 6,} , Dimitrios Karakitsos^{1, 7,} , Ziad A Memish^{3, 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

DOI

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/).

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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  - 2020/10/03
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  - 10.2991/jegh.k.200928.001
ID  - Alharthy2020
ER  -