Predictors of Intensive Care Unit Admission or Mortality in Patients with Coronavirus Disease 2019 Pneumonia in Istanbul, Turkey

Jpn J Infect Dis. 2021 Sep 22;74(5):458-464. doi: 10.7883/yoken.JJID.2020.1065. Epub 2021 Feb 26.

Abstract

We aimed to determine the predictors of intensive care unit (ICU) admission or death in patients with coronavirus disease 2019 (COVID-19) pneumonia. This retrospective, single-center study included patients aged ≥18 years who were diagnosed with COVID-19 pneumonia (laboratory and radiologically confirmed) between March 9 and April 8, 2020. The composite endpoint was ICU admission or in-hospital mortality. Univariate and multivariate logistic regression analyses were performed to evaluate the factors associated with the composite endpoint. A total of 336 patients with COVID-19 pneumonia were evaluated. The median age was 54 years (interquartile range: 21), and 187 (55.7%) were men. Fifty-one (15.2%) patients were admitted to the ICU. In-hospital mortality occurred in 33 patients (9.8%). In the univariate analysis, 17 parameters were associated with the composite endpoint, and procalcitonin had the highest odds ratio (odds ratio [OR] = 36.568, confidence interval [CI] = 5.145-259.915). Our results revealed that body temperature (OR = 1.489, CI = 1.023-2.167, P = 0.037), peripheral capillary oxygen saturation (SpO2) (OR = 0.835, CI = 0.773-0.901, P < 0.001), and consolidation (> 25%) on chest computed tomography (OR = 3.170, CI = 1.218-8.252, P = 0.018) at admission were independent predictors. As a result, increased body temperature, decreased SpO2, a high level of procalcitonin, and degree of consolidation on chest computed tomography may predict a poor prognosis and have utility in the management of patients.

Keywords: COVID-19 pneumonia; Turkey; in-hospital mortality; intensive care unit; predictors.

MeSH terms

  • Adult
  • Aged
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology*
  • COVID-19 / mortality
  • Female
  • Hospital Mortality
  • Hospitalization / statistics & numerical data*
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Turkey / epidemiology