Predictive factors of six-week mortality in critically ill patients with SARS-CoV-2: A multicenter prospective study.

Abstract

ObjectiveThe objective of the study is to identify the risk factors associated with mortality at six weeks, especially by analyzing the role of antivirals and munomodulators.DesignProspective descriptive multicenter cohort study.Setting26 Intensive care units (ICU) from Andalusian region in Spain.Patients or participantsConsecutive critically ill patients with confirmed SARS-CoV-2 infection were included from March 8 to May 30.InterventionsNone.VariablesVariables analyzed were demographic, severity scores and clinical condition. Support therapy, drug and mortality were analyzed. An univariate followed by multivariate Cox regression with propensity score analysis was applied.Results495 patients were enrolled, but 73 of them were excluded for incomplete data. Thus, 422 patients were included in the final analysis. Median age was 63 years and 305 (72.3%) were men. ICU mortality: 144/422 34%; 14 days mortality: 81/422 (19.2%); 28 days mortality: 121/422 (28.7%); 6-week mortality 152/422 36.5%. By multivariable Cox proportional analysis, factors independently associated with 42-day mortality were age, APACHE II score, SOFA score at ICU admission >6, Lactate dehydrogenase at ICU admission >470 U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72 h post-ICU admission <6.5%, and thrombocytopenia whereas the use of lopinavir/ritonavir was a protective factor.ConclusionAge, APACHE II, SOFA > value of 6 points, along with vasopressor requirements or renal replacement therapy have been identified as predictor factors of mortality at six weeks.Administration of corticosteroids showed no benefits in mortality, as did treatment with tocilizumab.Lopinavir/ritonavir administration is identified as a protective factor.