Factors That Influence Mortality in Critically Ill Patients with SARS-CoV-2 Infection: A Multicenter Study in the Kingdom of Saudi Arabia (original) (raw)
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International Journal of General Medicine
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Microbes and Infectious Diseases, 2021
Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic is a serious health problem all over the world including Egypt, thus realizing the predictive factors and disease's characteristics is an essential issue. Objectives: To evaluate the characteristics of laboratory-confirmed cases of SARS-CoV-2 infection in Fayoum governorate, Egypt, and to determine the predictive factors of disease severity. Methods: One hundred-fourty patients confirmed with SARS-CoV-2 from the Fayoum governorate, Egypt, were collected in this descriptive multicenter study. The subtype classification of SARS-CoV-2 was according to the World Health Organization (WHO) guideline SARS-CoV-2 disease severity classification. Patients were divided into a asymptomatic/non-severe cases group and a severe/critical case group. Each patient was subjected to chest computed tomography (CT), clinical, and laboratory assessment in form of complete blood count, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-tomonocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), liver function tests, urea, creatinine, C-reactive protein (CRP), serum ferritin, and D-dimer. Results: Severe/critical patients were older (52.0±12.6) with a statistical significantly higher rate of diabetes mellitus, hypertension, and tuberculosis (TB) (p<0.001) than non-severe cases. Dyspnea was the most prevalent significant symptom among severe /critical group (87.5%, p<0.001). A negative correlation between radiographic score and oxygenation index (r =-0.302, p=0.007). Using the ROC analysis, the area under curve (AUC) was highest for a radiographic score, D-dimer, CRP, ferritin, and NLR, with p<0.05 in severe/critical cases. Conclusions: Elevated CRP, D-dimer, serum ferritin, radiograph score, and NLR may contribute to the judgment of SARS-CoV-2 severity, and help clinicians to evaluate the patient's condition. Co-infection of SARS-CoV-2 and TB can occur, and may progress towards severe SARS-CoV-2.
Infection Epidemiology and Microbiology, 2021
Backgrounds: Coronavirus disease 2019 (COVID-19) pandemic is considered as a global health challenge, and Iran is among the top ten countries with the highest mortality rate. This study aimed to analyze epidemiological, clinical, and laboratory features of hospitalized SARS-CoV-2 infected patients and identify the risk factors of mortality among them to facilitate the prioritization of resources and vaccine allocation in the population using data available in a large university hospital in Tehran, Iran. Materials & Methods: From February 20 to May 14, 2020, a total of 684 COVID-19 confirmed cases were admitted to Imam Hossein University hospital in Tehran and enrolled in this retrospective observational study. Findings: The mean age of the participants was 59.48±16.65 years, and 55.8% were male. Compared to survivors, non-survivors (n=127, 18.57%) were older (69.09±14.16 vs. 57.29±16.40), had higher average number of comorbidities, and more frequently suffered from dyspnea, convulsion, loss of consciousness (LOC), tachycardia, tachypnea, and hypoxia. They also had higher levels of leukocytes, neutrophil count, C-reactive protein (CRP), creatine phosphokinase (CPK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), international normalized ratio (INR), prothrombin time (PT), partial thromboplastin time (PTT), urea, and serum creatinine (p<.05). Serum potassium (K), lymphocyte count, hemoglobin, HCO 3 , and serum sodium (Na) were significantly lower in non-survivors. Multivariable logistic regression analysis results revealed that nine variables were positively associated with mortality. Conclusion: Among COVID-19 patients admitted to the hospital, having more than two or three comorbidities, loss of consciousness, SpO2 < 90%, increased CRP, CPK, urea, and serum potassium, were associated with mortality.
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Characteristics of critically ill patients infected with COVID-19 in Abu Dhabi, United Arab Emirates
Anaesthesia Critical Care & Pain Medicine, 2020
, a novel coronavirus SARS-CoV-2 emerged in Wuhan city and extended around the globe. As of June 26, 2020, approximately 46,563 confirmed cases have been documented in the United Arab Emirates (UAE), with 308 deaths [1]. There are no reports describing patients admitted to the intensive care unit (ICU) with COVID-19 in the UAE. This study's primary objective was to describe the clinical characteristics of patients with laboratory-confirmed COVID-19 admitted to the ICU at Cleveland Clinic Abu Dhabi. A retrospective study was conducted for this purpose. A waiver of informed consent was obtained from the Ethics Committee at Cleveland Clinic Abu Dhabi (number: A-2020-035). All consecutive adult patients admitted to our ICU between March 31 and May 10, 2020, with confirmed SARS-CoV-2 infection (virus detected by a real time reverse transcriptase-polymerase chain reaction assay of a nasopharyngeal sample) were included. De-identified data from the electronic medical record were collected: comorbidities, laboratory data at ICU admission, arterial blood gas and respiratory mechanics data on admission and during the first 3 days. Continuous variables are expressed as mean AE SD or as median [interquartile range], and proportions were used for categorical variables. From March 31 to May 10, 2020, 508 adult patients with COVID-19 infection were admitted to the hospital. Among them, 55 patients (11%, 51 males) required ICU admission and were