Predictors of lethal COVID-19 in patients of intensive care unit

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Goal This study aimed to identify potential independent routine laboratory predictors of lethal COVID-19 in critically ill patients admitted to the ICU from August 1st to October 31st 2021, when the SARS-COV-2 delta variant prevailed in the region. Materials and Methods A retrospective single-center study case-control included 120 patients hospitalized to ICU №2 of the Samara Regional Clinical Hospital named after Seredavin from August 1st to October 31st 2021. The infection with SARS-COV-2 virus was verified with a real-time PCR test of the samples obtained from the nasopharynx. Results The study included 120 patients hospitalized to ICU with a severe form of ARDS caused by COVID-19-associated pneumonia. The results of the comparative analysis showed significant differences between the groups of survived and died patients when they were admitted to ICU. Died patients were older, had lower lymphocyte count, higher levels of glucose, ASAT, CPK, LDH, creatinine, BUN, and potassium, had lower cardiac output, and severe pulmonary lesions. Conclusion The single-center study included 120 patients with a severe form of COVID-19 that required their hospitalization to ICU. Univariate and multivariate regression analysis showed that the levels of LDH, BUN, glucose, ASAT, and lymphocyte count can act as independent predictors of the lethal outcome and have to be taken into account by ICU specialists during the evaluation of the clinical condition of patients for timely indication of the relevant therapy. The obtained data agree with previous studies that aimed to identify predictors of the severe course of COVID-19. However, further multi-center studies on larger cohorts of patients should be conducted for the identification of more precise associations between various predictors of lethality. It will help to reveal patients with a high risk of unfavorable outcomes after admission to ICU.