Relationship between clinical-epidemiological parameters and outcomes of patients with COVID-19 admitted to the intensive care unit: a report from a Brazilian hospital

Front Public Health. 2023 Sep 22:11:1241444. doi: 10.3389/fpubh.2023.1241444. eCollection 2023.

Abstract

Background: People in low-income countries, especially those with low socio-economic conditions, are likelier to test positive for SARS-CoV-2. The unequal conditions of public health systems also increase the infection rate and make early identification and treatment of at-risk patients difficult. Here, we aimed to characterize the epidemiological profile of COVID-19 patients in intensive care and identify laboratory and clinical markers associated with death.

Materials and methods: We conducted an observational, descriptive, and cross-sectional study in a reference hospital for COVID-19 treatment in the Southern Region of Bahia State, in Brazil, to evaluate the epidemiological, clinical, and laboratory characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Additionally, we used the area under the curve (AUC) to classify survivors and non-survivors and a multivariate logistic regression analysis to assess factors associated with death. Data was collected from the hospital databases between April 2020 and July 2021.

Results: The use of bladder catheters (OR 79.30; p < 0.0001) and central venous catheters (OR, 45.12; p < 0.0001) were the main factors associated with death in ICU COVID-19 patients. Additionally, the number of non-survivors increased with age (p < 0.0001) and prolonged ICU stay (p < 0.0001). Besides, SAPS3 presents a higher sensibility (77.9%) and specificity (63.1%) to discriminate between survivors and non-survivor with an AUC of 0.79 (p < 0.0001).

Conclusion: We suggest that multi-laboratory parameters can predict patient prognosis and guide healthcare teams toward more assertive clinical management, better resource allocation, and improved survival of COVID-19 patients admitted to the ICU.

Keywords: COVID-19; SAPS3; SARS-CoV-2; biomarkers; catheter; epidemiology; in-hospital mortality; intensive care unit.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brazil / epidemiology
  • COVID-19 Drug Treatment
  • COVID-19* / epidemiology
  • Cross-Sectional Studies
  • Hospitals
  • Humans
  • Intensive Care Units
  • SARS-CoV-2

Grants and funding

This research was received by the 2021 Lemann Brazil Research Fund.