Clinical, imaging, and laboratory characteristics of patients with COVID-19 according to ICU admission requirement in Cali, Colombia

Abstract

Introduction: At present, few studies conducted in Latin America have addressed the demographic, clinical, and laboratory characteristics of patients with COVID-19 and intensive care unit (ICU) admission requirement. Objective: To compare the sociodemographic, clinical, imaging, and laboratory characteristics of patients diagnosed with COVID-19 and treated in the emergency department of a hospital in Cali, Colombia, based on ICU admission requirement. Materials and methods: Retrospective and descriptive single cohort study conducted in 49 adults with COVID-19 treated in the emergency department of a quaternary care hospital in Cali (Colombia) between March and April 2020. Patients were divided into two groups: ICU admission requirement (n=24) and non-ICU admission requirement (n=25). Bivariate analyses were performed to determine differences between groups (chi-square, Fisher's exact, Student's t, and Mann-Whitney U tests), with a significance level of p<0.05. Results: Participants’ mean age was 53 years (SD=13) and 29 patients were men. Significant differences were found between groups in the following variables: mean age (ICU x̅=58 vs. Non-ICU x̅=49; p=0.020), presence of diabetes (8 vs. 1; p=0.010); presence of respiratory distress (20 vs. 11; p=0.007) ; unilateral or bilateral presence of areas of consolidation (12 vs. 3; p=0.005); median leukocyte (Med=7 570/mm3 vs. Med=5 130/mm3; p=0.0013), neutrophil (Med=5 980/mm3 vs. Med=3 450/mm3; p=0.0001) and lymphocyte (Med=865/mm3 vs. Med=1 400/mm3; p<0.0001) count; median C-reactive protein (Med=141,25mg/L vs. Med=27.95mg/L; p<0.001), ferritin (Med=1038ng/L vs. Med=542.5ng/L; p=0.0073) and lactate dehydrogenase (Med=391U/L vs. Med=248.5U/L, p=0.0014) levels. Finally, 15 patients required invasive mechanical ventilation, 2 presented with extubation failure, and 5 died. Conclusions. Significant differences were observed in the values of several inflammatory markers, cellular damage and complete blood count parameters between patients who required admission to the ICU and those who did not, so these variables could be used to develop tools that contribute to establishing the prognosis of this disease.

Keywords

• COVID-19
• Intensive Care Units
• Critical Care Outcomes
• Real-Time Polymerase Chain Reaction
• Biomarkers