Skip to main content Skip to main navigation menu Skip to site footer
Articles
Published: 2022-03-13

Effect of risk factors on the outcomes of COVID-19-infected intensive care patients: a single-center retrospective study

Department of Anaesthesia, 7 Air Force Hospital, Kanpur, Uttar Pradesh-208004, India.
Department of ENT, 7 Air Force Hospital, Kanpur, Uttar Pradesh-208004, India
Department of ENT, 7 Air Force Hospital, Kanpur, Uttar Pradesh-208004, India
Department of Anaesthesia, 7 Air Force Hospital, Kanpur, Uttar Pradesh-208004, India
Department of Anaesthesia, 7 Air Force Hospital, Kanpur, Uttar Pradesh-208004, India
Department of Anaesthesia, 7 Air Force Hospital, Kanpur, Uttar Pradesh-208004, India
Department of Anaesthesia, 7 Air Force Hospital, Kanpur, Uttar Pradesh-208004, India
Department of Anaesthesia, 7 Air Force Hospital, Kanpur, Uttar Pradesh-208004, India
Comorbidities, COVID-19, Mortality Rate, Morbidity Rate, Intensive Care Unit, Risk Factors, India

Abstract

Background: To date, little attention has been paid to the impact of risk factors on the outcome of patients with coronavirus disease 2019 (COVID-19) hospitalized in the intensive care unit (ICU). This study was performed to examine the effects of risk factors on death among COVID-19 patients hospitalized in the ICU. 

Methods: From April 2020 to November 2020, data on 141 COVID-19-infected intensive care patients at 7 Air Force Hospital, Kanpur, were retrospectively retrieved. All analyses were performed using SPSS statistical software (SPSS Inc., Chicago, IL, USA, 15.0). Bivariate and multivariate logistic regression analysis was done to identify independent risk factors. A p-value <0.05 was considered statistically significant.

Results: Most of study population were males (69.5%) with mean age of 59.8 ± 17.5 years. Out of 141 patients, 60 (42.6%) patients had comorbidities and 81 (57.4%) patients had no comorbidities. ICU death rates were 46.1%. Bivariate logistic regression analysis revealed that male sex (OR:0.45;95%CI:0.21-0.94), diabetes mellitus (OR:2.96; 95%CI:1.16-7.54), coronary artery disease (OR:2.48;95%CI:0.83-7.37), chronic kidney disease (OR:0.13,95% CI:0.02-1.12), patients with one (OR:1.25,95%CI:0.54-2.86) or more than two comorbidities (OR:1.95,95%CI:0.81-4.70), and who required high flow oxygen therapy (OR:13.30,95%CI:5.81-30.43), non-invasive (OR: 0.10,95% CI:0.02-0.45) and invasive ventilators (OR:0.04,95%CI:0.02-0.09) all were associated with higher ICU death rates. Multivariable logistic regression found following independent risk factors for death: patients with one comorbidity (OR:0.10;95%CI:0.02-0.66), non-invasive ventilator (OR:0.005;95%CI:0.000-0.091), and invasive ventilator (OR:0.003;95%CI:0.000-0.032).

Conclusion: Identification of risk factors is of utmost importance to reduce death in COVID-19 infected intensive care patients.



Downloads

Download data is not yet available.

References

  1. Elhadi M, Msherghi A, Alkeelani M, Zorgani A, Zaid A, Alsuyihili A, et al. Assessment of healthcare workers’ levels of preparedness and awareness regarding COVID-19 infection in low-resource settings. Am J Trop Med Hyg. 2020;103(2):828-33.https://doi.org/10.4269/ajtmh.20-0330
  2. Tabah A, Ramanan M, Laupland KB, Buetti N, Cortegiani A, Mellinghoff J, et al. Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): an international survey. J Crit Care. 2020;59:70-75.https://doi.org/10.1016/j.jcrc.2020.06.005
  3. Chen C-Y, Lee C-H, Liu C-Y, Wang J-H, Wang L-M, Perng R-P. Clinical features and outcomes of severe acute respiratory syndrome and predictive factors for acute respiratory distress syndrome. J Chin Med Assoc. 2005;68(1):4-10.https://doi.org/10.1016/s1726-4901(09)70124-8
  4. Al-Dorzi HM, Aldawood AS, Khan R, Baharoon S, Alchin JD, Matroud AA, et al. The critical care response to a hospital outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection: an observational study. Ann Intensive Care. 2016;6(1):1-11. https://doi.org/10.1186/s13613-016-0203-z
  5. Arabi YM, Arifi AA, Balkhy HH, Najm H, Aldawood AS, Ghabashi A, et al. Clinical course and outcomes of critically ill patients with Middle East respiratory syndrome coronavirus infection. Ann Intern Med. 2014;160(6):389-97.https://doi.org/10.7326/M13-2486
  6. Halim AA, Alsayed B, Embarak S, Yaseen T, Dabbous S. Clinical characteristics and outcome of ICU admitted MERS corona virus infected patients. Egypt J Chest Dis Tuberc. 2016;65(1):81-87.https://doi.org/10.1016/j.ejcdt.2015.11.011
  7. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020;34:101623.https://doi.org/10.1016/j.tmaid.2020.101623
  8. Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo FX, Chong M, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. JAMA. 2020;323(16):1612-14.https://doi.org/10.1001/jama.2020.4326
  9. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323(20):2052-59.https://doi.org/10.1001/jama.2020.6775
  10. Myers LC, Parodi SM, Escobar GJ, Liu VX. Characteristics of hospitalized adults with COVID-19 in an integrated health care system in California. JAMA. 2020;323(21):2195-98.https://doi.org/10.1001/jama.2020.7202
  11. Grasselli G, Greco M, Zanella A, Albano G, Antonelli M, Bellani G, et al. Risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA Intern Med. 2020;180(10):1345-55.https://doi.org/10.1001/jamainternmed.2020.3539
  12. Osibogun A, Balogun M, Abayomi A, Idris J, Kuyinu Y, Odukoya O, et al. Outcomes of COVID-19 patients with comorbidities in southwest Nigeria. PloS One. 2021;16(3):e0248281.https://doi.org/10.1371/journal.pone.0248281
  13. Bhatraju PK, Ghassemieh BJ, Nichols M, Kim R, Jerome KR, Nalla AK, et al. Covid-19 in critically ill patients in the Seattle region—case series. N Engl J Med. 2020;382(21):2012-22.https://doi.org/10.1056/NEJMoa2004500
  14. Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81.https://doi.org/10.1016/S2213-2600(20)30079-5
  15. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62.https://doi.org/10.1016/S0140-6736(20)30566-3
  16. Budhiraja S, Soni A, Jha V, Indrayan A, Dewan A, Singh O, et al. Clinical Profile of First 1000 COVID-19 cases admitted at tertiary care hospitals and the correlates of their mortality: an Indian experience. medRxiv. 2020:1-19.https://doi.org/10.1101/2020.11.16.20232223
  17. Guan W-j, Ni Z-y, Hu Y, Liang W-h, Ou C-q, He J-x, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.https://doi.org/10.1056/NEJMoa2002032
  18. Abate SM, Ahmed Ali S, Mantfardo B, Basu B. Rate of Intensive Care Unit admission and outcomes among patients with coronavirus: A systematic review and Meta-analysis. PloS one. 2020;15(7):e0235653.https://doi.org/10.1371/journal.pone.0235653
  19. Sharma G, Volgman AS, Michos ED. Sex differences in mortality from COVID-19 pandemic: are men vulnerable and women protected? Case Reports. 2020;2(9):1407-10.https://dx.doi.org/10.1016%2Fj.jaccas.2020.04.027
  20. Ayoade B, Salami B, Agboola A, Tade A, Adekoya A, Olatunji A, et al. Beliefs and practices associated with late presentation in patients with breast cancer; an observational study of patient presenting in a tertiary care facility in Southwest Nigeria. J Afr Cance. 2015;7(4):178-85.https://doi.org/10.1007/s12558-015-0404-7
  21. Ulasi II, Ijoma CK. The enormity of chronic kidney disease in Nigeria: the situation in a teaching hospital in South-East Nigeria. J Trop Med. 2010:1-6.https://doi.org/10.1155/2010/501957
  22. Adejumo OA, Akinbodewa AA, Ogunleye A, Enikuomehin AC, Lawal OM. Cost implication of inpatient care of chronic kidney disease patients in a tertiary hospital in Southwest Nigeria. Saudi J Kidney Dis Transpl. 2020;31(1):209-14.https://doi.org/10.4103/1319-2442.279942
  23. Anudeep A, Somu C, Kumar J. Clinical profile and outcomes of critically ill covid-19 patients admitted in a tertiary care hospital. Ann Trop Med Public Health. 2020;23(19):232-141.https://doi.org/10.36295/ASRO.2020.232141
  24. Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2020;395(10225):709-33.https://doi.org/10.1016/S0140-6736(20)30045-3
  25. Loffi M, Piccolo R, Regazzoni V, Di Tano G, Moschini L, Robba D, et al. Coronary artery disease in patients hospitalized with Coronavirus disease 2019 (COVID-19) infection. Open heart. 2020;7(2):e001428.https://doi.org/10.1136/openhrt-2020-001428
  26. Liang C, Zhang W, Li S, Qin G. Coronary heart disease and COVID-19: A meta-analysis. Medicina Clínica (English Edition). 2021;156(11):547-54.https://doi.org/10.1016/j.medcle.2020.12.021
  27. Guan W-j, Liang W-h, Zhao Y, Liang H-r, Chen Z-s, Li Y-m, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. European Respiratory Journal. 2020;55(5).https://dx.doi.org/10.1183%2F13993003.00547-2020
  28. Ferreira JC, Ho Y-L, Besen BAMP, Malbouisson LMS, Taniguchi LU, Mendes PV, et al. Protective ventilation and outcomes of critically ill patients with COVID-19: a cohort study. Annals of intensive care. 2021;11(1):1-11. https://doi.org/10.1186/s13613-021-00882-w


How to Cite

1.
Sapra A, VU J, Jha S, HN M, Muzammil M, Majumdar M, Arya JS, Sheoran A. Effect of risk factors on the outcomes of COVID-19-infected intensive care patients: a single-center retrospective study. jidhealth [Internet]. 2022 Mar. 13 [cited 2024 Apr. 26];5(1):630-6. Available from: https://www.jidhealth.com/index.php/jidhealth/article/view/186