Clinical features and prognostic factors of intensive and non-intensive 1014 COVID-19 patients: an experience cohort from Alahsa, Saudi Arabia

Abstract

Background COVID-19 is a worldwide pandemic and has placed significant demand for acute and critical care services on hospitals in many countries. Objectives To determine the predictors of severe COVID-19 disease requiring admission to an ICU by comparing patients who were ICU admitted to non-ICU groups. Methods A cohort study was conducted for the laboratory-confirmed COVID-19 patients who were admitted to six Saudi Ministry of Health’s hospitals in Alahsa, between March 1, 2020, and July 30, 2020, by reviewing patient’s medical records retrospectively. Results This cohort included 1014 patients with an overall mean age of 47.2 ± 19.3 years and 582 (57%) were males. A total of 205 (20%) of the hospitalized patients were admitted to the ICU. Hypertension, diabetes and obesity were the most common comorbidities in all study patients (27.2, 19.9, and 9%, respectively). The most prevalent symptoms were cough (47.7%), shortness of breath (35.7%) and fever (34.3%). Compared with non-ICU group, ICU patients had older age (p ≤ 0.0005) and comprised a higher proportion of the current smokers and had higher respiratory rates (p ≤ 0.0005), and more percentage of body temperatures in the range of 37.3–38.0 °C (p ≥ 0.0005); and had more comorbidities including diabetes (p ≤ 0.0005), hypertension (p ≥ 0.0005), obesity (p = 0.048), and sickle cell disease (p = 0.039). There were significant differences between the non-ICU and ICU groups for fever, shortness of breath, cough, fatigue, vomiting, dizziness; elevated white blood cells, neutrophils, alanine aminotransferase and alkaline aminotransferase, lactate dehydrogenase, and ferritin, and decreased hemoglobin; and proportion of abnormal bilateral chest CT images (p < 0.05). Significant differences were also found for multiple treatments (p < 0.05). ICU patients group had a much higher mortality rate than those with non-ICU admission (p ≤ 0.0005). Conclusion Identifying key clinical characteristics of COVID-19 that predict ICU admission and high mortality can be useful for frontline healthcare providers in making the right clinical decision under time-sensitive and resource-constricted environment.

Examining the Clinical Prognosis of Critically Ill Patients with COVID-19 Admitted to Intensive Care Units: A Nationwide Saudi Study

“…Fatigue, a sore throat, muscle ache, a headache and chest pain were found to be less common and abdominal pain, a loss of smell and a loss of taste were the least common presenting complaints. This finding is similar to previous studies; however, the lower rates of the loss of smell and taste have been previously suggested to be a result of underreporting and neglect by those who suffer from a severe infection [ 14 , 15 , 16 , 17 , 18 ]. Our study used multiple logistic regression and discovered that age, nationality and ethnicity, the duration of mechanical ventilation, SOFA score and the presence of IHD were significant predictors of the survival rate.…”

Coinfections with Bacteria, Fungi, and Respiratory Viruses in Patients with SARS-CoV-2: A Systematic Review and Meta-Analysis

“…In addition, the included studies comprised only admitted patients, which may skew the findings and should not be generalized to all SARS-COV-2 patients. Non-admitted COVID-19 patients were not represented in these studies and thus the exact prevalence of coinfections could not be calculated for all SARS-CoV-2 infected patients [ 83 , 84 , 85 ]. The findings in this meta-analysis showed different results from previous systematic meta-analyses that evaluated coinfections among COVID-19 patients [ 71 , 72 , 73 ].…”

Diabetic ketoacidosis in patients with SARS-CoV-2: a systematic review and meta-analysis

“…Moreover, increasing age in combination with male gender and BMI ≥ 30 might denote seriously sick patients who can potentially have more morbidity and propensity to die. The majority of patients hospitalized with SARS-CoV-2 are older and seemed to have underlying medical conditions [ 97 , 98 ], with increased age being associated with clinical severity, including case fatality [ 97 , 99 ]. Fortunately, however, mortality from DKA in elderly people have also declined dramatically during the past 10 years [ 100 ].…”