Factors associated with poor outcomes among hospitalized patients with COVID-19: Experience from a MERS-CoV referral hospital
| Autor: | Muath Alotaibi, Layan Akkielah, Nouf Althabit, Sara Alhasani, Mohamad-Hani Temsah, Abdulaziz AlRajhi, Mazin Barry, Ali Alhijji, Abdulwahab Aldrees, Jaffar A. Al-Tawfiq, Thamer Nouh, Abdulellah Almohaya |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Referral Middle East respiratory syndrome coronavirus medicine.medical_treatment Infectious and parasitic diseases RC109-216 medicine.disease_cause Tachypnea law.invention law Internal medicine medicine Humans Invasive mechanical ventilation Referral and Consultation Retrospective Studies Mechanical ventilation SARS-CoV-2 business.industry Public Health Environmental and Occupational Health COVID-19 Retrospective cohort study General Medicine Intensive care unit Hospitals Intensive Care Units Infectious Diseases Blood pressure Risk factors ICU Middle East Respiratory Syndrome Coronavirus Original Article Female Public aspects of medicine RA1-1270 medicine.symptom business |
| Zdroj: | Journal of Infection and Public Health, Vol 14, Iss 11, Pp 1658-1665 (2021) Journal of Infection and Public Health |
| ISSN: | 1876-0341 |
| Popis: | Background: Coronavirus disease 2019 (COVID-19) has resulted in millions of deaths, including more than 6000 deaths in the Kingdom of Saudi Arabia (KSA). Identifying key predictors of intensive care unit (ICU) admission and mortality among infected cases would help in identifying individuals at risk to optimize their care. We aimed to determine factors of poor outcomes in hospitalized patients with COVID-19 in a large academic hospital in Riyadh, KSA that serves as a Middle East Respiratory Syndrome coronavirus (MERS-CoV) referral center. Methods: This is a single-center retrospective cohort study of hospitalized patients between March 15 and August 31, 2020. The study was conducted at King Saud University Medical City (KSUMC). COVID-19 infection was confirmed using real-time reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-COV-2. Demographic data, clinical characteristics, laboratory, radiological features, and length of hospital stay were obtained. Poor outcomes were, admission to ICU, need for invasive mechanical ventilation (IMV), and in-hospital all-cause mortality. Results: Out of 16,947 individuals tested in KSUMC, 3480 (20.5%) tested positive for SARS-CoV-2 and of those 743 patients (21%) were hospitalized. There were 62% males, 77% were younger than 65 years. Of all cases, 204 patients (28%) required ICU admission, 104 (14%) required IMV, and 117 (16%) died in hospital. In bivariate analysis, multiple factors were associated with mortality among COVID-19 patients. Further multivariate analysis revealed the following factors were associated with mortality: respiratory rate more than 24/min and systolic blood pressure 37 units/L in the first 48 h of presentation, while a RT-PCR cycle threshold (Ct) value ≤24 was a predictor for IMV. Conclusion: Variable factors were identified as predictors of different outcomes among COVID-19 patients. The only predictor of IMV was a low initial Ct values of SARS-CoV-2 PCR. The presence of tachypnea, hypotension, lymphopenia, and elevated AST in the first 48 h of presentation were independently associated with mortality. This study provides possible independent predictors of mortality and invasive mechanical ventilation. The data may be helpful in the early identification of high-risk COVID-19 patients in areas endemic with MERS-CoV. |
| Databáze: | OpenAIRE |
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