Clinical Predictors of COVID-19 Mortality Among Patients in Intensive Care Units: A Retrospective Study

Abbas Al Mutair; Alya Al Mutairi; Abdul Rehman Zia Zaidi; Samer Salih; Saad Alhumaid; Ali A Rabaan; Awad Al-Omari

doi:10.2147/IJGM.S313757

Clinical Predictors of COVID-19 Mortality Among Patients in Intensive Care Units: A Retrospective Study

Int J Gen Med. 2021 Jul 21:14:3719-3728. doi: 10.2147/IJGM.S313757. eCollection 2021.

Authors

Abbas Al Mutair^{1

2

3}, Alya Al Mutairi⁴, Abdul Rehman Zia Zaidi^{5

6}, Samer Salih⁵, Saad Alhumaid⁷, Ali A Rabaan⁸, Awad Al-Omari^{5

6}

Affiliations

¹ Research Center, Almoosa Specialist Hospital, Al-Ahsa, 31982, Saudi Arabia.
² Research Center, College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh, Saudi Arabia.
³ School of Nursing, University of Wollongong, Wollongong, Australia.
⁴ Department of Mathematics, Faculty of Science, Taibah University, Medina, 54321, Saudi Arabia.
⁵ Research Center, Dr. Sulaiman Al Habib Medical Group, Riyadh, 12214, Saudi Arabia.
⁶ College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
⁷ Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa, Saudi Arabia.
⁸ Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.

Abstract

Objective: The ongoing pandemic of the coronavirus disease 2019 (COVID-19), which originated from Wuhan, China, has been identified to be caused by the novel beta coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has been spreading rapidly worldwide within just a few months. Our aims were to analyze clinical and laboratory abnormalities in ICU patients with COVID-19, in order to define which predictors can distinguish between those who are at higher risk of developing fatal versus non-fatal forms of the disease.

Methods: A descriptive cross-sectional survey was used; demographics, comorbidities, symptoms, laboratory parameters at ICU admission, and clinical outcomes for the adult patients admitted to ICU were collected from five hospitals in Saudi Arabia.

Results: A total of 86 patients with COVID-19 admitted in ICU, 50 patients died, 23 recovered, and 13 were still admitted, with a mortality rate of 58.1%. Septic shock (OR (95% CI): 58.1 (5.97-7812.8), p < 0.001) and acute kidney injury (AKI) (OR (95% CI): 7.279 (1.191-65.43), p = 0.032) had a significant impact on mortality. Cox proportional-hazards regression analysis revealed that septic shock (HR (95% CI): 9.502 (2.958-30.524), p < 0.001) and neutrophil count (HR (95% CI): 1.053 (1.023-1.085), p < 0.001) were significant predictors for mortality.

Conclusion: Septic shock, AKI, and high neutrophil count were found to be predictive of death in these patients. Further studies are needed to aid efficient recognition and management of severe COVID-19 patients in our population. .

Keywords: COVID-19; Saudi Arabia; intensive care units; mortality; severe acute respiratory syndrome coronavirus 2.

Grants and funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.