TO STUDY THE PREDICTORS OF MORBIDITY & MORTALITY IN CRITICALLY ILL PATIENTS OF COVID 19 IN ICU & THEIR OUTCOMES

Abstract

World is now recovering from COVID-19 pandemic which started about 3 years ago in Hubei, China. Many patients were severely affected ending up in intensive care units. It is observed by clinicians that biochemical markers such as LDH, Ferritin, Interleukin-6, D-dimer, and C-reactive protein, as well as radiological parameters such as CT severity scores, can predict morbidity and mortality in COVID-19 patients. Haematological parameters such as lymphopenia , increased neutrophil to lymphocyte ratio also indicate severe disease and poor prognosis. Materials And Methods: This was retrospective observational study conducted in tertiary care centre in Marathwada region of Maharashtra, India. Patient's details like age, sex, symptoms, comorbidity, highest mode of ventilation and ICU stay duration were noted in the case record form (CRF) in each case. CT Chest, inammatory biomarker and CBC for lymphocyte & Platelet were noted. Among non-survivors, the Observations And Results: most prevalent symptom was breathlessness, followed by cough, fever, and sore throat . Breathlessness (p value 0.003), reduced urinary output (p value 0.004), and chest pain (p value 0.0002) were statistically signicant predictors of higher mortality. Comorbidities such as diabetes mellitus (, pulmonary conditions (COPD and asthma), and chronic kidney disease were also associated with higher mortality. Additionally, higher CT severity scores were correlated with increased mortality, as were elevated levels of biomarkers such as D-dimer, LDH, Ferritin, IL-6, CRP, and reduced lymphocyte and platelet counts. The study showed that ICU admission had a statistically signicant impact on patient outcomes (p<0.00001). The study found that advanced age, co-morbidities such as diabetes mellitus, Conclusion: asthma, COPD, and chronic kidney disease, symptoms such as breathlessness, reduced urinary output, and chest pain, a higher CT severity score, elevated levels of biomarkers such as CRP, LDH, ferritin, IL-6, D-dimer, creatinine, and the N/L ratio, thrombocytopenia, and lymphopenia were all associated with higher mortality in critically ill COVID-19 pneumonia patients