Risk factors for intensive care unit admission and mortality in hospitalized COVID-19 patients
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: This study investigated the clinical features and outcome of hospitalized coronavirus disease 2019 (COVID-19) patients admitted to our quaternary care hospital. Methods: In this retrospective cohort study, we included all adult patients with COVID-19 infection admitted to a quaternary care hospital in Pakistan from March 1 to April 15, 2020. The extracted variables included demographics, comorbidities, presenting symptoms, laboratory tests and radiological findings during admission. Outcome measures included in-hospital mortality and length of stay. Results: Sixty-six COVID-19 patients were hospitalized during the study period. Sixty-one percent were male and 39% female; mean age was 50.6±19.1 years. Fever and cough were the most common presenting symptoms. Serial chest X-rays showed bilateral pulmonary opacities in 33 (50%) patients. The overall mortality was 14% and mean length of stay was 8.4±8.9 days. Ten patients (15%) required intensive care unit (ICU) care during admission, of which six (9%) were intubated. Age ≥60 years, diabetes, ischemic heart disease, ICU admission, neutrophil to lymphocyte ratio ≥3.3, and international normalized ratio ≥1.2 were associated with increased risk of mortality. Conclusions: We found a mortality rate of 14% in hospitalized COVID-19 patients. COVID-19 cases are still increasing exponentially around the world and may overwhelm healthcare systems in many countries soon. Our findings can be used for early identification of patients who may require intensive care and aggressive management in order to improve outcomes.
Abstract
Background: This study investigated the clinical features and outcome of hospitalized coronavirus disease 2019 (COVID-19) patients admitted to our quaternary care hospital. Methods: In this retrospective cohort study, we included all adult patients with COVID-19 infection admitted to a quaternary care hospital in Pakistan from March 1 to April 15, 2020. The extracted variables included demographics, comorbidities, presenting symptoms, laboratory tests and radiological findings during admission. Outcome measures included in-hospital mortality and length of stay. Results: Sixty-six COVID-19 patients were hospitalized during the study period. Sixty-one percent were male and 39% female; mean age was 50.6±19.1 years. Fever and cough were the most common presenting symptoms. Serial chest X-rays showed bilateral pulmonary opacities in 33 (50%) patients. The overall mortality was 14% and mean length of stay was 8.4±8.9 days. Ten patients (15%) required intensive care unit (ICU) care during admission, of which six (9%) were intubated. Age ≥60 years, diabetes, ischemic heart disease, ICU admission, neutrophil to lymphocyte ratio ≥3.3, and international normalized ratio ≥1.2 were associated with increased risk of mortality. Conclusions: We found a mortality rate of 14% in hospitalized COVID-19 patients. COVID-19 cases are still increasing exponentially around the world and may overwhelm healthcare systems in many countries soon. Our findings can be used for early identification of patients who may require intensive care and aggressive management in order to improve outcomes.
참고문헌 (23)
- Fauci AS, "Covid-19 : navigating the uncharted", N Engl J Med, 382, pp.1268~1269 (2020)
- Li Q, "Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia", N Engl J Med, 382, pp.1199~1207 (2020)
- "Novel corona virus (COVID-19)–healthMap" (2020)[URL]
- Chen N, "Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China : a descriptive study", Lancet, 395, pp.507~513 (2020)
- Mehta P, "COVID-19 : consider cytokine storm syndromes and immunosuppression", Lancet, 395, pp.1033~1034 (2020)
- Guan WJ, "Clinical characteristics of coronavirus disease 2019 in China", N Engl J Med, 382, pp.1708~1720 (2020)
- Goyal P, "Clinical characteristics of Covid-19 in New York City", N Engl J Med, 382, pp.2372~2374 (2020)
- Onder G, "Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy", JAMA, 323, pp.1775~1776 (2020)
- Huang C, "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China", Lancet, 395, pp.497~506 (2020)
- Wang D, "Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China", JAMA, 323, pp.1061~1069 (2020)
- Mao B, "Assessing risk factors for SARS-CoV-2 infection in patients presenting with symptoms in Shanghai, China : a multicentre, observational cohort study", Lancet Digit Health, 2, pp.e323~e330 (2020)
- Ai T, "Correlation of chest CT and RT-PCR testing for coronavirus disease 2019(COVID-19)in China : a report of 1014 cases", Radiology, 296, pp.E32~E40 (2020)
- Huang P, "Use of chest CT in combination with negative RT-PCR assay for the 2019novel coronavirus but high clinical suspicion", Radiology, 295, pp.22~23 (2020)
- Chung M, "CT imaging features of 2019 novel coronavirus(2019-nCoV)", Radiology, 295, pp.202~207 (2020)
- Volpicelli G, "What’s new in lung ultrasound during the COVID-19 pandemic", Intensive Care Med, 46, pp.1445~1448 (2020)
- Tang W, "Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019 : open label, randomised controlled trial", BMJ, 369, pp.m1849~ (2020)
- Beigel JH, "Remdesivir for the treatment of Covid-19 : final report", N Engl J Med, 383, pp.1813~1826 (2020)
- Mahase E, "Coronavirus covid-19 has killed more people than SARS and MERS combined, despite lower case fatality rate", BMJ, 368, pp.m641~ (2020)
- Gudbjartsson DF, "Spread of SARS-CoV-2 in the Icelandic population", N Engl J Med, 382, pp.2302~2315 (2020)
- Arentz M, "Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State", JAMA, 323, pp.1612~1614 (2020)
- Bhatraju PK, "Covid-19 in critically ill patients in the Seattle region : case series", N Engl J Med, 382, pp.2012~2022 (2020)
- Yang J, "Prevalence of comorbidities and its effects in patients infected with SARSCoV-2 : a systematic review and meta-analysis", Int J Infect Dis, 94, pp.91~95 (2020)
- Rodriguez-Morales AJ, "Clinical, laboratory and imaging features of COVID-19 : a systematic review and meta-analysis", Travel Med Infect Dis, 34, pp.101623~ (2020)