Infection and Drug Resistance (Aug 2023)

Epidemiological Characteristics and Outcomes Predictors for Intensive Care Unit COVID-19 Patients in Al-Madinah, Saudi Arabia. Retrospective Cohort Study

  • Alhoufie ST,
  • Mumena WA,
  • Alsharif N,
  • Makhdoom HM,
  • Almutawif YA,
  • Alfarouk KO,
  • Alharbi MZ,
  • Aljabri K,
  • Aljifri A

Journal volume & issue
Vol. Volume 16
pp. 5573 – 5586

Abstract

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Sari T Alhoufie,1 Walaa A Mumena,2 Naif Alsharif,3 Hatim M Makhdoom,1 Yahya A Almutawif,1 Khalid O Alfarouk,4 Mohammed Z Alharbi,3 Khaled Aljabri,3 Alanoud Aljifri5 1Medical Laboratories Technology Department, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munwarah, Saudi Arabia; 2Department of Clinical Nutrition, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munwarah, Saudi Arabia; 3King Salman Medical City, Al-Madinah General Hospital, Al-Madinah Al-Munwarah, Saudi Arabia; 4Zamzam University College, Khartoum, Sudan; 5Al-Madinah Health Cluster, Ministry of Health, Al-Madinah Al-Munwarah, Saudi ArabiaCorrespondence: Sari T Alhoufie, Medical Laboratories Technology Department, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munwarah, Saudi Arabia, Email [email protected]: The global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) increased the demand for intensive care unit (ICU) services. Mortality and morbidity rates among ICU COVID-19 patients are affected by several factors, such as severity, comorbidities, and coinfections. In this study, we describe the demographic characteristics of COVID-19 patients admitted to an ICU in Saudi Arabia, and we determined the predictors for mortality and prolonged ICU length of stay. Additionally, we determined the prevalence of bacterial coinfection and its effect on the outcomes for ICU COVID-19 patients.Methods: We retrospectively studied the medical records of 142 COVID-19 patients admitted to the ICU at a tertiary hospital in Madinah, Saudi Arabia. Data on demographics, medical history, mortality, length of stay, and presence of coinfection were collected for each patient.Results: Neutrophil-to-Lymphocyte ratio (NLR) and intubation were reliable predictors of mortality and ICU length of stay among these ICU COVID-19 patients. Moreover, bacterial coinfections were detected in 23.2% of the patients and significantly (p < 0.001) prolonged their ICU length of stay, explaining the 10% increase in the length of stay for these patients. Furthermore, mortality reached 70% among the coinfected patients, and 60.8% of the isolated coinfecting pathogens were multidrug-resistant (MDR) strains of Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus.Conclusion: Increased NLR and intubation are predictors of mortality and prolonged length of stay in COVID-19 patients admitted to the ICU. Coinfection with MDR bacterial strains potentially results in complications and is a high-risk factor for prolonged ICU length of stay.Keywords: COVID-19, mortality, neutrophil-to-lymphocyte ratio, ICU length of stay, coinfection, MDR bacteria, Al-Madinah, Saudi Arabia

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