A Retrospective Study of the factors associated with deterioration severity of Coronavirus Disease-2019 illness at a tertiary hospital in Saudi Arabia

Abstract

Background: Coronavirus Disease-2019 (COVID-19) has rapidly progressed to a pandemic causing a severe burden on healthcare systems worldwide. COVID-19 has seriously threatened specific populations, such as the elderly and those with chronic illnesses. Objective: In this study, we aim to determine risk factors contributing to and affecting COVID-19 severity and deterioration during illness. Methods: This is a retrospective cohort study of patients with a confirmed COVID-19 diagnosis and admitted to JHAH from March to July 2020. Results: A total of 639 patients were included in this study. The vast majority were Saudi patients (87.3%). 465 (76%) were symptomatic with abnormal x-ray imaging diagnosis (56.2%). The predetermined clinical risk factors include obesity (46.3%); hypertension (42.3%); diabetes mellitus (41.8%); dyslipidemia (39%); ischemic heart disease (13.2%); chronic lung disease (11%); chronic kidney disease (10.3%); cancer (7.9%); congestive heart failure (6.1%); and immunocompromised patients (4.6%). However, most of these patients were stable upon admission (82.1%), while 9.7% were severely or critically ill. Ordinal regression analysis revealed that age, chest x-ray finding upon diagnosis, and presenting symptoms upon admission significantly impacted the deterioration pattern. Conclusion: This study found that elderly and chronically ill patients are at higher risk for more severe COVID-19 infection and risk of deterioration, hospitalization, intensive care unit admission, and probably death when compared to younger and healthier patients.