Acute and Critical Care (Feb 2022)

Clinical characteristics and outcomes of critically ill COVID-19 patients in Sfax, Tunisia

  • Mabrouk Bahloul,
  • Sana Kharrat,
  • Kamilia Chtara,
  • Malek Hafdhi,
  • Olfa Turki,
  • Najeh Baccouche,
  • Rania Ammar,
  • Nozha Kallel,
  • Majdi Hsairi,
  • Olfa Chakroun-Walha,
  • Chokri Ben Hamida,
  • Hedi Chelly,
  • Khaiereddine Ben Mahfoudh,
  • Abelhamid Karoui,
  • Hela Karray,
  • Noureddine Rekik,
  • Mounir Bouaziz

DOI
https://doi.org/10.4266/acc.2021.00129
Journal volume & issue
Vol. 37, no. 1
pp. 84 – 93

Abstract

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Background Africa, like the rest of the world, has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. However, only a few studies covering this subject in Africa have been published. Methods We conducted a retrospective study of critically ill adult COVID-19 patients—all of whom had a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection—admitted to the intensive care unit (ICU) of Habib Bourguiba University Hospital (Sfax, Tunisia). Results A total of 96 patients were admitted into our ICU for respiratory distress due to COVID-19 infection. Mean age was 62.4±12.8 years and median age was 64 years. Mean arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) ratio was 105±60 and ≤300 in all cases but one. Oxygen support was required for all patients (100%) and invasive mechanical ventilation for 38 (40%). Prone positioning was applied in 67 patients (70%). Within the study period, 47 of the 96 patients died (49%). Multivariate analysis showed that the factors associated with poor outcome were the development of acute renal failure (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.75–25.9), the use of mechanical ventilation (OR, 5.8; 95% CI, 1.54–22.0), and serum cholinesterase (SChE) activity lower than 5,000 UI/L (OR, 5.0; 95% CI, 1.34–19). Conclusions In this retrospective cohort study of critically ill patients admitted to the ICU in Sfax, Tunisia, for acute respiratory failure following COVID-19 infection, the mortality rate was high. The development of acute renal failure, the use of mechanical ventilation, and SChE activity lower than 5,000 UI/L were associated with a poor outcome.

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