Outcomes and risk factors for death in patients with coronavirus disease-2019 (COVID-19) pneumonia admitted to the intensive care units of an Egyptian University Hospital. A retrospective cohort study. Issue 10 (October 2021)

• Record Type: Journal Article
• Authors: Nassar, Yasser; Mokhtar, Ahmed; Elhadidy, Amr; Elsayed, Marwa; Mostafa, Farouk; Rady, Ashraf; Eladawy, Akram; Elshazly, Mostafa; Saeed, Mohamed; Mokhtar, Sherif; Buschbeck, Samuel; Sakr, Yasser
• Is Part Of: Journal of infection and public health. Volume 14:Issue 10(2022)
• Page Start: 1381
• Page End: 1388
• Publication Date: 2021-10
• Subjects: ALT Alanine aminotransferase -- AST Aspartate transaminase -- APACHE II Acute Physiology and Chronic Health Evaluation II -- BMI Body mass index -- COVID-19 Coronavirus disease-2019 -- CRP C-reactive protein -- ECMO Extracorporeal membrane oxygenation -- HFO High flow oxygen therapy -- FiO2 Fraction of inspired oxygen -- ICU Intensive Care unit -- IQ Interquartile range -- IU International unit -- LDH Lactate dehydrogenase -- PCO2 Partial pressure of carbon dioxide -- PO2 Partial pressure of oxygen -- SaO2 Arterial oxygen concentration -- SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 -- SD Standard deviation; SARS-CoV-2 -- COVID-19 -- Ischemic heart disease -- Intensive care unit -- Hospital mortality; Communicable diseases -- Periodicals; Public health -- Periodicals; Epidemiology -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Medical microbiology -- Periodicals; 614.4
• DOI: 10.1016/j.jiph.2021.06.012
• Languages: English
• ISSNs: 1876-0341

Abstract

Highlights: In this Egyptian cohort of critically ill patients with COVID-19 around 23% of patients had no known comorbid conditions. SARS-CoV-2 infections were associated with high morbidity rate most commonly, acute kidney injury, thrombocytopenia, and secondary bacterial infections. Some 24% of patients died in-hospital within a median of 10 days following ICU admission, Ischemic heart disease, history of smoking, and the occurrence of bacterial pneumonia were independently associated with a higher risk of in-hospital death. Abstract: Background: The characteristics, outcomes, and risk factors for in-hospital death of critically ill intensive care unit (ICU) patients with coronavirus disease-2019 (COVID-19) have been described in patients from Europe, North America and China, but there are few data from COVID-19 patients in Middle Eastern countries. The aim of this study was to investigate the characteristics, outcomes, and risk factors for in-hospital death of critically ill patients with COVID-19 pneumonia admitted to the ICUs of a University Hospital in Egypt. Methods: Retrospective analysis of patients with COVID-19 pneumonia admitted between April 28 and July 29, 2020 to two ICUs dedicated to the isolation and treatment of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Cairo University Hospitals. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples and radiologic evidence of pneumonia. Results: Of the 177 patients admitted to the ICUs during the study period, 160 patients had COVID-19 pneumonia and were included in the analysis (mean age: 60 ± 14 years, 67.5% males); 23% of patients had no known comorbidities. The overall ICU and hospital mortality rates were both 24.4%. The ICU and hospital lengths of stay were 7 (25–75% interquartile range: 4–10) and 10 (25–75% interquartile range: 7–14) days, respectively. In a multivariable analysis with in-hospital death as the dependent variable, ischemic heart disease, history of smoking, and secondary bacterial pneumonia were independently associated with a higher risk of in-hospital death, whereas greater PaO2 /FiO2 ratio on admission to the ICU was associated with a lower risk. Conclusion: In this cohort of critically ill patients with COVID-19 pneumonia, ischemic heart disease, history of smoking, and secondary bacterial pneumonia were independently associated with a higher risk of in-hospital death.