Characteristics and Risk Factors Associated With Mortality in Critically Ill Patients With COVID-19

Cureus. 2021 Apr 12;13(4):e14442. doi: 10.7759/cureus.14442.

Abstract

Purpose To describe clinical characteristics and outcomes of ICU patients with COVID-19 and to investigate differences between survivors and non-survivors. Methods Demographics, symptoms, laboratory values, comorbidities and outcomes were extracted retrospectively from the medical records of ICU patients with confirmed COVID-19 pneumonia from the Elisabeth-TweeSteden Hospital in Tilburg, the Netherlands from March until June 2020. Primary outcome was 28-day mortality and secondary outcomes were differences between survivors and non-survivors. Results Between March 1 and June 4, 2020, 114 patients with COVID-19 were admitted to the ICU. There were 83 (72.8%) survivors and 31 (27.2%) non-survivors. Non-survivors were significantly older (72.0 years [interquartile range, IQR 67.0-76.0] versus 65.0 years [IQR 58.0-73.0], P = 0.002), had a significantly higher Acute Physiology And Chronic Health Evaluation (APACHE) score (54 [IQR 45-72] versus 43 [IQR 36-53], P < 0.001) and Sequential Organ Failure Assessment (SOFA) score (7 [IQR 4-7] versus 5 [IQR 3-6], P = 004). cTnT values were significantly higher in non-survivors due to more myocarditis (83.9% versus 40.8%, P < 0.001). A multivariate Cox regression model revealed SOFA score (hazard ratio, HR 1.337, 95% CI 1.131-1.582, P = 0.001) to be an independent predictor of 28-day mortality. Conclusion We demonstrated a 28-day mortality rate of 27.2% in our cohort. These patients were older and presented with a higher severity of illness and more organ failure.

Keywords: morbidity and mortality; pulmonology and critical care; sars-cov-2 (severe acute respiratory syndrome coronavirus -2).