Characteristics and Risk Factors Associated With Mortality in Critically Ill Patients With COVID-19

Abstract

To describe clinical characteristics and outcomes of ICU patients with COVID-19 and to investigate differences between survivors and non-survivors. MethodsDemographics, symptoms, laboratory values, comorbidities and outcomes were extracted retrospectively from the medical records of ICU patients with confirmed COVID-19 pneumonia from the Elisabeth-TweeSteden Hospital in Tilburg, the Netherlands from March until June 2020. Primary outcome was 28-day mortality and secondary outcomes were differences between survivors and non-survivors. ResultsBetween March 1 and June 4, 2020, 114 patients with COVID-19 were admitted to the ICU. There were 83 (72.8%) survivors and 31 (27.2%) non-survivors. Non-survivors were significantly older (72.0 years [interquartile range, IQR 67.0-76.0] versus 65.0 years [IQR 58.0-73.0], P = 0.002), had a significantly higher Acute Physiology And Chronic Health Evaluation (APACHE) score (54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72) versus 43 [IQR 36-53], P < 0.001) and Sequential Organ Failure Assessment (SOFA) score versus 5 [IQR 3-6], P = 004). cTnT values were significantly higher in non-survivors due to more myocarditis (83.9% versus 40.8%, P < 0.001). A multivariate Cox regression model revealed SOFA score (hazard ratio, HR 1.337, 95% CI 1.131-1.582, P = 0.001) to be an independent predictor of 28-day mortality. ConclusionWe demonstrated a 28-day mortality rate of 27.2% in our cohort. These patients were older and presented with a higher severity of illness and more organ failure.

Clinical Characteristics and Outcomes of COVID-19 Acute Respiratory Distress Syndrome (ARDS) Survivors in Early Pandemic: A Single Healthcare System Retrospective Study

“…This highlights the importance of preventative management and targeted vaccination strategies towards patients with COPD. We found an in-hospital mortality of 38.2%, which is consistent with similar studies in the early phase of the pandemic that have suggested mortality rates of 27.2%-61.5% [ 5 , 8 , 12 - 13 ]. The wide range of mortality may be due to the different endpoints used in studies that are typically either in-hospital or 30-day mortality.…”

“…In this retrospective study, we have attempted to explore the clinical characteristics and outcomes of ARDS patients in an urban population during the early phase of the COVID-19 pandemic. In terms of our demographics, our study had an average age of 64 for the total cohort, which is consistent with prior studies that have also reported an average age of intubated patients of around 64-68 years of age [5][6]8]. Also consistent with prior studies --hypertension, type 2 diabetes mellitus, and obesity were the most common co-morbidities [8].…”

“…Approximately 5%-10% of cases require intensive care with severe symptoms that result in respiratory failure and multiorgan failure [ 4 - 5 ]. Mortality in critically-ill patients with COVID-19 has been reported anywhere between 27.2% and 48.8%[ 2 , 5 ], and respiratory complications are the most common cause of mortality [ 6 ].…”

“…Approximately 5%-10% of cases require intensive care with severe symptoms that result in respiratory failure and multiorgan failure [ 4 - 5 ]. Mortality in critically-ill patients with COVID-19 has been reported anywhere between 27.2% and 48.8%[ 2 , 5 ], and respiratory complications are the most common cause of mortality [ 6 ]. Despite efforts to develop targeted pharmaceutical therapy to treat this disease, there remains limited data to support optimal settings for mechanical ventilation and for management of adjuvant therapies in COVID-19-associated acute respiratory distress syndrome (ARDS).…”

Predictive Value of Systemic Immune-inflammation Index in Determining Mortality in COVID-19 Patients

“…In the study of Leonardo et al, a significant correlation was found between mortality with RDW and APACHE-II score [24]. In their study, Vogels et al revealed that the SOFA score is an independent predictor of mortality in COVID-19 patients [25]. We also used the rapid Sequential Organ Failure Assessment (qSOFA) score, which is generally used to predict in-hospital mortality and intensive care unit admission in patients with sepsis, in our study [26].…”