Characteristics, Management And Outcomes Of Critically Ill Covid-19 Patients Admitted To Icu In Hospitals In Bangladesh: A Retrospective Study

Abstract

Objectives: This study aimed to analyse the epidemiological and clinical characteristics of critical COVID-19 cases and investigate risk factors including comorbidities and age in relation with the clinical aftermath of COVID-19 in critical cases in Bangladesh. Methods: In this retrospective study, epidemiological and clinical characteristics, complications, laboratory results, and clinical management of the patients were studied from data obtained from 168 individuals diagnosed with an advanced prognosis of COVID-19 admitted in two hospitals in Bangladesh. Results: Individuals in the study sample contracted COVID-19 through community transmission. 56.5% (n = 95) cases died in intensive care units (ICU) during the study period. The median age was 56 years and 79.2% (n=134) were male. Typical clinical manifestation included Acute respiratory distress syndrome (ARDS) related complications (79.2%), fever (54.2%) and cough (25.6%) while diabetes mellitus (52.4%), hypertension (41.1%) and heart diseases (16.7%) were the conventional comorbidities. Clinical outcomes were detrimental due to comorbidities rather than age and comorbid individuals over 50 were at more risk. In the sample, oxygen saturation was low (< 95% SpO2) in 135 patients (80.4%) and 158 (93.4%) patients received supplemental oxygen. Identical biochemical parameters were found in both deceased and surviving cases. Administration of antiviral drug Remdesivir and the glucocorticoid, Dexamethasone increased the proportion of surviving patients slightly. Conclusions: Susceptibility to developing critical illness due to COVID-19 was found more in comorbid males. These atypical patients require more clinical attention from the prospect of controlling mortality rate in Bangladesh.

COVID-19-specific diabetes worries amongst diabetic patients: The role of social support and other co-variates

“…This is in agreement with a previous study which showed that more than half of participants with diabetes were worried about being affected by COVID-19 [25]. Research suggests that a substantial majority of hospitalized patients with COVID-19 are individuals with diabetes [43][44][45]. Diabetic patients have shown to be susceptible to life-threatening infections such SARs, MERs, H191, possibly as a result of a dysregulated immune response [45,46].…”

Clinical characteristics and outcomes of COVID-19 infected diabetic patients admitted in ICUs of the southern region of Bangladesh

“…However, the presence of hypertension was positively correlated with death, ICU care and severity [ 12 ]. Worth mentioning, hypertension has not been found to make any significant difference in the mortality rate among the critical COVID-19 cases in Bangladesh [ 16 ]. Data obtained from a study in the U.K. suggest that mortality rate does not increase with hypertension, while the presence of uncontrolled and controlled diabetes along with hypertension increases the risk 2.36 and 1.50 fold respectively [ 29 ].…”

“…In China, a more extensive study on 72,314 patients with COVID-19 reported that the mortality rate in patients with diabetes was threefold compared to the mortality rate of COVID-19 in patients overall [ 15 ]. A previous study conducted in Bangladeshi on patients with COVID-19 admitted in ICUs found that over 50% of the patients (52.4%) seeking care in the ICUs had diabetes [ 16 ].…”

Asthma in Adult Patients with COVID-19. Prevalence and Risk of Severe Disease

“…In nine studies conducted in South Korea (n = 37,938) (70,(118)(119)(120)(121)(122)(123)(124)(125), the pooled prevalence was 5.4% (95 % CI, 2.3-9.6%). Data regarding asthma prevalence in people with COVID-19 in Canada ( 126), Brazil (127-129), India (130,131), Bangladesh (132,133), the Philippines (134), Japan (135,136), Africa (137)(138)(139)(140), Iran (141,142), Kuwait (143), Turkey (144)(145)(146), Israel (147)(148)(149), and Saudi Arabia (150) were relatively sparse, making them difficult to characterize by country, but they were generally within the range of the prevalences reported above.…”