Pulmonary Therapy (Jul 2023)

Predictive Factors of Mortality in Patients with Severe COVID-19 Treated in the Intensive Care Unit: A Single-Center Study in Vietnam

  • Sy Duong-Quy,
  • Duc Huynh-Truong-Anh,
  • Thanh Nguyen-Thi-Kim,
  • Tien Nguyen-Quang,
  • Thuy Tran-Ngoc-Anh,
  • Nam Nguyen-Van-Hoai,
  • Mai Do-Thi-Thu,
  • Thanh Nguyen-Chi,
  • Toi Nguyen-Van,
  • Tram Tang-Thi-Thao,
  • Anh Nguyen-Tuan,
  • Quan Nguyen-Hoang,
  • Phung Hoang-Phi-Tuyet,
  • Giap Vu-Van,
  • Hieu Nguyen-Lan,
  • Chuong Nguyen-Hong,
  • Sy Dinh-Ngoc,
  • Dung Truong-Viet,
  • Vinh Nguyen-Nhu,
  • Thai Nguyen-Duy

DOI
https://doi.org/10.1007/s41030-023-00231-1
Journal volume & issue
Vol. 9, no. 3
pp. 377 – 394

Abstract

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Abstract Introduction The fourth outbreak of COVID-19 with the delta variant in Vietnam was very fierce due to the limited availability of vaccines and the lack of healthcare resources. During that period, the high mortality of patients with severe and critical COVID-19 caused many concerns for the health system, especially the intensive care units. This study aimed to analyze the predictive factors of death and survival in patients with severe and critical COVID-19. Methods We conducted a cross-sectional and descriptive study on 151 patients with severe and critical COVID-19 hospitalized in the Intensive Care Unit of Binh Duong General Hospital. Results Common clinical symptoms of severe and critical COVID-19 included shortness of breath (97.4%), fatigue (89.4%), cough (76.8%), chest pain (47.7%), loss of smell (48.3%), loss of taste (39.1%), and headache (21.2%). The abnormal biochemical features were leukopenia (2.1%), anemia, thrombocytopenia (18%), hypoxia with low PaO2 (34.6%), hypocapnia with reduced PaCO2 (29.6%), and blood acidosis (18.4%). Common complications during hospitalization were septic shock (15.2%), cardiogenic shock (5.3%), and embolism (2.6%). The predictive factors of death were being female, age > 65 years, cardiovascular comorbidity, thrombocytopenia (< 137.109/l), and hypoxia at inclusion or after the first week or blood acidosis (pH < 7.28). The use of a high dose of corticosteroids reduced the mortality during the first 3 weeks of hospitalization but significantly increased risk of death after 3 and 4 weeks. Conclusions Common clinical symptoms, laboratory features, and death-related complications of critical and severe COVID-19 patients were found in Vietnamese patients during the fourth wave of the COVID-19 pandemic. The results of this study provide new insight into the predictive factors of mortality for patients with severe and critical COVID-19.

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