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

Abstract

Study objectiveStudy the clinical outcomes associated with the number of concomitant vasopressors used in critically ill COVID-19 patients. DesignA single-center retrospective cohort study was conducted on patients admitted with COVID-19 to the intensive care unit (ICU) between March and October 2020. SettingRush University Medical Center, United States. ParticipantsAdult patients at least 18 years old with COVID-19 with continuous infusion of any vasopressors were included. Main outcome measures60-day mortality in COVID-19 patients by the number of concurrent vasopressors received. ResultsA 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. ConclusionCritically ill patients with COVID-19 requiring vasopressors were associated with significantly higher 60-day mortality.