Treatment Outcomes of Mechanically Ventilated Patients with COVID-19 and Associated Factors among Hospitalized Patients at ICU of SPHMMC, Addis Ababa, Ethiopia

Abstract

Introduction: Coronavirus (CoV) is derived from the word ‘corona’ meaning ‘crown’ in Latin. Coronavirus causes a range of human respiratory tract infections varying from mild cold to severe respiratory distress syndrome. Nowadays, due to the limited number of ICU beds and ventilators and the increasing number of patients with COVID-19 infection requiring MV data on patient characteristics, and outcomes of critical illness from COVID-19 are needed to inform decision-making about resource allocation, critical care capacity, and treatment of patients. Objectives: To assess outcomes and associated factors of patients with COVID-19 on mechanical ventilation at SPHMMC COVID ICU, Addis Ababa, Ethiopia, 2020 G.C. Methods: A single center cross-sectional study was used. All consecutive ICU admitted patients with RT-PCR confirmed COVID-19 and received mechanical ventilation support during the first 5 months were included. Data was collected from patient’s medical records using a structured questionnaire and the collected data was entered and analyzed using SPSS version 24. Results: A total of 104 ICU patients with COVID-19 were included. The majority, 73.1% were male; the median age was 60 (IQR; 45-70) years, with 36.5% patients having at least one chronic medical condition. Out of 165, 104(63%) patients needed mechanical ventilation. Invasive and noninvasive ventilation were used in 93(89.4%) and 11(10.6%) patients, respectively. The most common treatments used by the patients were steroid (100%), antibiotics (99%) and vaso-pressors (57.7%). Experimental antiviral therapy was used in only 1% (n=1) of patients. Overall the ICU mortality was 14.6% and 88.5% among mechanically ventilated patients. Being fatigue (AOR=7.599; 95% CI: 1.65-35.12), IMV (AOR=5.28; 95% CI: 1.01-27.71), and septic shock (AOR=12.83; 95% CI: 1.46-13.11) were a significant risk factors for the ICU outcomes of the patients. Conclusion: The study showed high proportion of mortality among ICU patients who received mechanical ventilator support with low rate of discharge. Male patients and old age groups with co-morbidity were disproportionately affected by the disease condition.