Association between number of vasopressors and mortality in COVID-19 patients

Abstract

Study objective: Study the clinical outcomes associated with the number of concomitant vasopressors used in critically ill COVID-19 patients.

Design: A single-center retrospective cohort study was conducted on patients admitted with COVID-19 to the intensive care unit (ICU) between March and October 2020.

Setting: Rush University Medical Center, United States.

Participants: Adult patients at least 18 years old with COVID-19 with continuous infusion of any vasopressors were included.

Main outcome measures: 60-day mortality in COVID-19 patients by the number of concurrent vasopressors received.

Results: A total of 637 patients met our inclusion criteria, of whom 338 (53.1 %) required the support of at least one vasopressor. When compared to patients with no vasopressor requirement, those who required 1 vasopressor (V1) (adjusted odds ratio [aOR] 3.27, 95 % confidence interval (CI) 1.86-5.79, p < 0.01) (n = 137), 2 vasopressors (V2) (aOR 4.71, 95 % CI 2.54-8.77, p < 0.01) (n = 86), 3 vasopressors (V3) (aOR 26.2, 95 % CI 13.35-53.74 p < 0.01) (n = 74), and 4 or 5 vasopressors(V4-5) (aOR 106.38, 95 % CI 39.17-349.93, p < 0.01) (n = 41) were at increased risk of 60-day mortality. In-hospital mortality for patients who received no vasopressors was 6.7 %, 22.6 % for V1, 27.9 % for V2, 62.2 % for V3, and 78 % for V4-V5.

Conclusion: Critically ill patients with COVID-19 requiring vasopressors were associated with significantly higher 60-day mortality.

Keywords: 60-day mortality; COVID-19; Intensive care unit; Shock; Vasopressors.