Abstract
BackgroundSince the first COVID-19 patient in Saudi Arabia (March, 2020) more than 338,539 cases and approximately 4996 dead were reported. We present the main characteristics and outcomes of critically ill COVID-19 patients that were admitted in the largest Ministry of Health Intensive Care Unit (ICU) in Saudi Arabia.MethodsThis retrospective study, analyzed routine epidemiologic, clinical, and laboratory data of COVID-19 critically ill patients in King Saud Medical City (KSMC), Riyadh, Saudi Arabia, between March 20, 2020 and May 31, 2020. Severe acute respiratory syndrome coronavirus-2 infection was confirmed by real-time reverse transcriptase polymerase chain reaction assays performed on nasopharyngeal swabs in all enrolled cases. Outcome measures such as 28-days mortality, duration of mechanical ventilation, and ICU length of stay were analyzed.ResultsThree-hundred-and-fifty-two critically ill COVID-19 patients were included in the study. Patients had a mean age of 50.63 ± 13.3 years, 87.2% were males, and 49.4% were active smokers. Upon ICU admission, 56.8% of patients were mechanically ventilated with peripheral oxygen saturation/fraction of inspired oxygen (SpO2/FiO2) ratio of 158 ± 32. No co-infections with other endemic viruses were observed. Duration of mechanical ventilation was 16 (IQR: 8–28) days; ICU length of stay was 18 (IQR: 9–29) days, and 28-day mortality was 32.1%. Multivariate regression analysis showed that old age [Odds Ratio (OR): 1.15, 95% Confidence Intervals (CI): 1.03–1.21], active smoking [OR: 3, 95% CI: 2.51–3.66], pulmonary embolism [OR: 2.91, 95% CI: 2.65–3.36), decreased SpO2/FiO2 ratio [OR: 0.94, 95% CI: 0.91–0.97], and increased lactate [OR: 3.9, 95% CI: 2.4–4.9], and d-dimers [OR: 2.54, 95% CI: 1.57–3.12] were mortality predictors.ConclusionOld age, active smoking, pulmonary embolism, decreased SpO2/FiO2 ratio, and increased lactate and d-dimers were predictors of 28-day mortality in critically ill COVID-19 patients.
Highlights
The novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) disease (COVID-19) emerged in Wuhan, China, and spread worldwide
Exclusion criteria were: (1) Negative RT-PCR result for COVID-19 in two consecutive samples taken 48 h apart, (2) patients that were transferred to other COVID-19 designated hospitals based on our Ministry of Health (MOH) surge plan, and (3) Health care workers with nosocomial acquisition of SARS-CoV-2 infection
Chest Computed Tomographic (CT) scans were performed in 51.1% of cases, and showed bilateral ground-glass opacities with variable pulmonary parenchymal consolidations, which were consistent with COVID-19 pneumonia
Summary
The novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) disease (COVID-19) emerged in Wuhan, China, and spread worldwide. The first case of COVID-19 in Saudi Arabia was confirmed on March 2, 2020, and since more than 338,539 cases with more than 4996 dead were reported [2,3]. Several studies analyzed the factors affecting morbidity and mortality in hospitalized patients with COVID-19 [15,16,17,18,19,20,21,22,23,24]. Since the first COVID-19 patient in Saudi Arabia (March, 2020) more than 338,539 cases and approximately 4996 dead were reported. We present the main characteristics and outcomes of critically ill COVID-19 patients that were admitted in the largest Ministry of Health Intensive Care Unit (ICU) in Saudi Arabia
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