Clinical Predictors of COVID-19 Mortality Among Patients in Intensive Care Units: A Retrospective Study

Abstract

Abbas Al Mutair,1– 3 Alya Al Mutairi,4 Abdul Rehman Zia Zaidi,5,6 Samer Salih,5 Saad Alhumaid,7 Ali A Rabaan,8 Awad Al-Omari5,6 1Research Center, Almoosa Specialist Hospital, Al-Ahsa, 31982, Saudi Arabia; 2Research Center, College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh, Saudi Arabia; 3School of Nursing, University of Wollongong, Wollongong, Australia; 4Department of Mathematics, Faculty of Science, Taibah University, Medina, 54321, Saudi Arabia; 5Research Center, Dr. Sulaiman Al Habib Medical Group, Riyadh, 12214, Saudi Arabia; 6College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; 7Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa, Saudi Arabia; 8Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi ArabiaCorrespondence: Alya Al Mutairi Email [email protected]: The ongoing pandemic of the coronavirus disease 2019 (COVID-19), which originated from Wuhan, China, has been identified to be caused by the novel beta coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has been spreading rapidly worldwide within just a few months. Our aims were to analyze clinical and laboratory abnormalities in ICU patients with COVID-19, in order to define which predictors can distinguish between those who are at higher risk of developing fatal versus non-fatal forms of the disease.Methods: A descriptive cross-sectional survey was used; demographics, comorbidities, symptoms, laboratory parameters at ICU admission, and clinical outcomes for the adult patients admitted to ICU were collected from five hospitals in Saudi Arabia.Results: A total of 86 patients with COVID-19 admitted in ICU, 50 patients died, 23 recovered, and 13 were still admitted, with a mortality rate of 58.1%. Septic shock (OR (95% CI): 58.1 (5.97– 7812.8), p < 0.001) and acute kidney injury (AKI) (OR (95% CI): 7.279 (1.191– 65.43), p = 0.032) had a significant impact on mortality. Cox proportional-hazards regression analysis revealed that septic shock (HR (95% CI): 9.502 (2.958– 30.524), p < 0.001) and neutrophil count (HR (95% CI): 1.053 (1.023– 1.085), p < 0.001) were significant predictors for mortality.Conclusion: Septic shock, AKI, and high neutrophil count were found to be predictive of death in these patients. Further studies are needed to aid efficient recognition and management of severe COVID-19 patients in our population. Keywords: COVID-19, severe acute respiratory syndrome coronavirus 2, intensive care units, Saudi Arabia, mortality

Keywords

• covid-19
• severe acute respiratory syndrome coronavirus 2
• intensive care units
• saudi arabia
• mortality