Proportion and prognosis of ICU-admitted coronavirus disease 2019-infected patients in relation to all hospitalized cases in Abbasia Chest Hospital, Cairo

Abstract

Background Because of the outbreak of coronavirus disease 2019 (COVID-19), there has been an increase in the demand for intensive care services all over the world. Severe cases fulfill one of the following criteria: respiratory rate more than 30/min, oxygen saturation less than or equal to 93%, and PaO2/FiO2 less than or equal to 300 mmHg. ICU admission is required for seriously ill patients who require high-flow nasal cannula, intubation, or more oxygen to treat hypoxemia or multiple organ dysfunctions. However, it is unclear whether patients with COVID-19 who are admitted to the ICU will survive. Aim To estimate the proportion and prognosis of ICU-admitted COVID cases in relation to whole COVID cases admitted at Abbassia Chest Hospital and estimation of risk factors responsible for mortality. Patients and methods This retrospective observational study was conducted on all cases of COVID-19-infected patients admitted at respiratory ICU of Abbassia Chest Hospital in relation to all hospitalized cases during the period between January 2021 and June 2021. All of the cases were subjected to full history taking, laboratory investigations, and radiological assessment with chest radiograph and computed tomography. The reported outcomes included weaning from mechanical ventilation, discharge, mortality, and cause of death. Results The study included 76 patients with COVID-19. Overall, 43 (56.6%) were males and 33 (43.4%) were females, with a mean age of 57.17 ± 12.54 years. The incidence of mortality was 32.9%. The acute respiratory distress syndrome (ARDS) was the most common cause for ICU admission and encountered in 57.4% of the cases. All of the dead cases had severe ARDS. The use of invasive mechanical ventilation was reported in 76.5% of the included died cases, and this was statistically significantly higher as compared with the survived group. On the contrary, the length of ICU stay was statistically significantly higher in the survived group. Conclusion COVID-19 infection is associated with a high percentage of ICU admission with a high mortality rate. Many factors are associated with the high risk of mortality among the ICU admitted COVID-19-infected patients including severe ARDS, deterioration of the systemic organ functions, and the utilization of invasive mechanical ventilation.

Keywords

• acute respiratory distress syndrome
• chest icu
• coronavirus disease 2019
• epidemic
• mortality