Risk factors for intensive care admission in patients with COVID-19 pneumonia: A retrospective study
Background: Coronavirus disease 2019 (COVID-19)-associated mortality is predominantly due to respiratory failure. However, risk factors and predictive models for disease progression in patients with COVID-19 are not consistent across the globe. In this study, we aimed to assess the risk factors asso...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Journal of Infection and Public Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034123001831 |
| _version_ | 1827907526244433920 |
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| author | Abdullah Mobeireek Saud AlSaleh Loui Ezzat Osama Al-saghier Sultan Al-Amro Abdulla Al-Jebreen Armen Torchyan Mohammed AlHajji Liju Ahmed |
| author_facet | Abdullah Mobeireek Saud AlSaleh Loui Ezzat Osama Al-saghier Sultan Al-Amro Abdulla Al-Jebreen Armen Torchyan Mohammed AlHajji Liju Ahmed |
| author_sort | Abdullah Mobeireek |
| collection | DOAJ |
| description | Background: Coronavirus disease 2019 (COVID-19)-associated mortality is predominantly due to respiratory failure. However, risk factors and predictive models for disease progression in patients with COVID-19 are not consistent across the globe. In this study, we aimed to assess the risk factors associated with intensive care (ICU) admission and mortality in patients with COVID-19 pneumonia. Methods: Information was retrieved from the database of all patients admitted with COVID-19 pneumonia between March 2020 and July 2020 at a tertiary care center in Saudi Arabia. The patients’ demographic, clinical, laboratory and radiological characteristics were analyzed. Results: Of 1054 patients admitted with PCR proven COVID-19, 254 patients (24%) with radiological evidence of pneumonia were enrolled. The median age was 55, with 25.6% above 65 years and 55.1% males. The comorbidities included hypertension (45%), diabetes (43%), dyslipidemia (24%), solid organ and bone marrow transplantation (14.5%), malignancy (13.4%), ischemic heart disease (10.6%) and chronic kidney disease (9.4%). The mortality rate was 4.7%, and 22.8% were admitted to the ICU.The risk factors for ICU admission were> 65 years of age (RR: 1.74, CI 95%, 1.10–2.74, p = 0.017), diabetes melitus (RR: 1.66, CI 95% 1.06–2.62, p = 0.028), heart failure (RR: 2.51, CI 95%, 1.28–4.93, p = 0.007), respiratory rate> 25 (RR: 2.75, CI 95%, 1.66–4.55, p < 0.001), upper lobe involvement (RR: 1.68, CI 95%, 1.02–2.77, p = 0.043), and C-reactive protein (CRP)> 140 (RR: 1.89, CI 95%, 1.14–3.13, p = 0.013).The risk factors for mortality were> 65 years of age (RR: 5.82, CI 95%, 1.81–18.68, p = 0.003), upper lobe involvement on chest radiography (RR:4.40, CI 95%, 1.22–15.86, p = 0.016), diffuse chest computed tomography changes (RR: 7.36, CI 95%, 2.31–23.46, p < 0.011), ischemic heart disease (RR: 4.20, CI 95%, 1.36–13.04, p = 0.028), chronic kidney disease (RR: 6.85, CI 95%, 2.35–19.90, p < 0.003), cerebrovascular disease (RR:13.61, CI 95%, 5.01–36.96 p < 0.001), respiratory rate> 25 (RR: 3.94, CI 95%, 1.32–11.78 p = 0.023), oxygen saturation< 90% on admission (RR: 12.19, CI 95%, 3.71–40.01, p < 0.001), thrombocytopenia (RR:4.16, CI 95%, 1.37–12.64, p = 0.013), and elevated troponin (RR: 6.20, CI 95%, 1.73–22.24, p = 0.003). Conclusions: In this study, nearly a quarter of the patients with COVID-19 pneumonia required intensive care. We identified several risk factors associated with ICU admission and mortality that may be useful for predicting, triaging, and managing COVID-19 pneumonia patients. However, these findings need to be validated prospectively. |
| first_indexed | 2024-03-13T01:09:27Z |
| format | Article |
| id | doaj.art-1e5ee16eaebc4de29f8b89915f3f6cd3 |
| institution | Directory Open Access Journal |
| issn | 1876-0341 |
| language | English |
| last_indexed | 2024-03-13T01:09:27Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj.art-1e5ee16eaebc4de29f8b89915f3f6cd32023-07-06T04:17:32ZengElsevierJournal of Infection and Public Health1876-03412023-08-0116812301235Risk factors for intensive care admission in patients with COVID-19 pneumonia: A retrospective studyAbdullah Mobeireek0Saud AlSaleh1Loui Ezzat2Osama Al-saghier3Sultan Al-Amro4Abdulla Al-Jebreen5Armen Torchyan6Mohammed AlHajji7Liju Ahmed8Department of Medicine, King Faisal Specialist Hospital and Resaerch Centre, Riyadh, Saudi Arabia; Alfaisal University, College of Medicine, Riyadh, Saudi Arabia,; Correspondence to: King Faisal Specialist Hospital & Research Centre, P.O. Box 3354 (MBC 46), Riyadh 11211, Saudi Arabia.Department of Medicine, King Faisal Specialist Hospital and Resaerch Centre, Riyadh, Saudi ArabiaDepartment of Medicine, King Faisal Specialist Hospital and Resaerch Centre, Riyadh, Saudi ArabiaDepartment of Medicine, King Faisal Specialist Hospital and Resaerch Centre, Riyadh, Saudi ArabiaDepartment of Radiology, King Faisal Specialist Hospital and Resaerch Centre, Riyadh, Saudi Arabia,Department of Radiology, King Faisal Specialist Hospital and Resaerch Centre, Riyadh, Saudi Arabia,Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi ArabiaDepartment of Medicine, King Faisal Specialist Hospital and Resaerch Centre, Riyadh, Saudi Arabia; Alfaisal University, College of Medicine, Riyadh, Saudi Arabia,Department of Medicine, King Faisal Specialist Hospital and Resaerch Centre, Madinah Al-Munawwarah, Saudi Arabia,Background: Coronavirus disease 2019 (COVID-19)-associated mortality is predominantly due to respiratory failure. However, risk factors and predictive models for disease progression in patients with COVID-19 are not consistent across the globe. In this study, we aimed to assess the risk factors associated with intensive care (ICU) admission and mortality in patients with COVID-19 pneumonia. Methods: Information was retrieved from the database of all patients admitted with COVID-19 pneumonia between March 2020 and July 2020 at a tertiary care center in Saudi Arabia. The patients’ demographic, clinical, laboratory and radiological characteristics were analyzed. Results: Of 1054 patients admitted with PCR proven COVID-19, 254 patients (24%) with radiological evidence of pneumonia were enrolled. The median age was 55, with 25.6% above 65 years and 55.1% males. The comorbidities included hypertension (45%), diabetes (43%), dyslipidemia (24%), solid organ and bone marrow transplantation (14.5%), malignancy (13.4%), ischemic heart disease (10.6%) and chronic kidney disease (9.4%). The mortality rate was 4.7%, and 22.8% were admitted to the ICU.The risk factors for ICU admission were> 65 years of age (RR: 1.74, CI 95%, 1.10–2.74, p = 0.017), diabetes melitus (RR: 1.66, CI 95% 1.06–2.62, p = 0.028), heart failure (RR: 2.51, CI 95%, 1.28–4.93, p = 0.007), respiratory rate> 25 (RR: 2.75, CI 95%, 1.66–4.55, p < 0.001), upper lobe involvement (RR: 1.68, CI 95%, 1.02–2.77, p = 0.043), and C-reactive protein (CRP)> 140 (RR: 1.89, CI 95%, 1.14–3.13, p = 0.013).The risk factors for mortality were> 65 years of age (RR: 5.82, CI 95%, 1.81–18.68, p = 0.003), upper lobe involvement on chest radiography (RR:4.40, CI 95%, 1.22–15.86, p = 0.016), diffuse chest computed tomography changes (RR: 7.36, CI 95%, 2.31–23.46, p < 0.011), ischemic heart disease (RR: 4.20, CI 95%, 1.36–13.04, p = 0.028), chronic kidney disease (RR: 6.85, CI 95%, 2.35–19.90, p < 0.003), cerebrovascular disease (RR:13.61, CI 95%, 5.01–36.96 p < 0.001), respiratory rate> 25 (RR: 3.94, CI 95%, 1.32–11.78 p = 0.023), oxygen saturation< 90% on admission (RR: 12.19, CI 95%, 3.71–40.01, p < 0.001), thrombocytopenia (RR:4.16, CI 95%, 1.37–12.64, p = 0.013), and elevated troponin (RR: 6.20, CI 95%, 1.73–22.24, p = 0.003). Conclusions: In this study, nearly a quarter of the patients with COVID-19 pneumonia required intensive care. We identified several risk factors associated with ICU admission and mortality that may be useful for predicting, triaging, and managing COVID-19 pneumonia patients. However, these findings need to be validated prospectively.http://www.sciencedirect.com/science/article/pii/S1876034123001831Respiratory failureCOVID-19 pneumoniaIntensive care unit |
| spellingShingle | Abdullah Mobeireek Saud AlSaleh Loui Ezzat Osama Al-saghier Sultan Al-Amro Abdulla Al-Jebreen Armen Torchyan Mohammed AlHajji Liju Ahmed Risk factors for intensive care admission in patients with COVID-19 pneumonia: A retrospective study Journal of Infection and Public Health Respiratory failure COVID-19 pneumonia Intensive care unit |
| title | Risk factors for intensive care admission in patients with COVID-19 pneumonia: A retrospective study |
| title_full | Risk factors for intensive care admission in patients with COVID-19 pneumonia: A retrospective study |
| title_fullStr | Risk factors for intensive care admission in patients with COVID-19 pneumonia: A retrospective study |
| title_full_unstemmed | Risk factors for intensive care admission in patients with COVID-19 pneumonia: A retrospective study |
| title_short | Risk factors for intensive care admission in patients with COVID-19 pneumonia: A retrospective study |
| title_sort | risk factors for intensive care admission in patients with covid 19 pneumonia a retrospective study |
| topic | Respiratory failure COVID-19 pneumonia Intensive care unit |
| url | http://www.sciencedirect.com/science/article/pii/S1876034123001831 |
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