Factors associated with mortality in critically ill patients with COVID-19

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DOI:

https://doi.org/10.17058/reci.v12i4.17388

Abstract

Background and objectives: COVID-19 is a life-threatening disease. Recognizing the main characteristics of the disease and its main complications will help future interventions, care, and management of health services since territorial and population diversities directly influence health outcomes. Our main objective is to describe the clinical characteristics, outcomes, and factors associated with mortality of patients with COVID-19 admitted to the intensive care unit of a public and tertiary hospital. Methods: Cohort study, conducted from March 1 to September 30, 2020. Poisson regression was performed to investigate the variables of hospital treatment as potential risk factors for in-hospital mortality. Results: Of the 283 eligible patients in this study, the hospital mortality rate was of 41.7% (n=118). The most common outcomes were acute respiratory distress syndrome, nosocomial infection, and septic shock. Factors independently associated with increased risk of death were age greater than 51 years old (RR=1.7, 95%CI=1.0-2.8), especially over 70 years old (RR=2.9, 95%CI=1.7-2.8), current smoker (RR=1.8, 95%CI=1.1-2.9), requiring the use of inotrope (RR=1.4, 95%CI=1.0-2.0), and presenting potassium greater than 5.0 mEq/l on admission (RR=1.3, 95%CI=1.0-1.7).

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References

Mcintosh K, Hirsch MS, Bloom, A. Coronavirus disease 2019 (COVID-19): Epidemiology, virology, and prevention. UpToDate, 2020a https://library.fitnessformulary.com/wp-content/uploads/Coronavirus-disease-2019-COVID-19_-Epidemiology-virology-and-prevention-UpToDate.pdf

World Health Organization (WHO). Coronavirus disease (COVID-19) Weekly Epidemiological Update and Weekly Operational Update. Genebra: WHO, 2020a. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

World Health Organization (WHO). Coronavirus disease (COVID-19) pandemic. WHO, 2020b. https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Chang R, Elhusseiny KM, Yeh YC, et al. COVID-19 ICU and mechanical ventilation patient characteristics and outcomes-A systematic review and meta-analysis. PLoS One. 202; 16(2): e0246318 https://doi.org/10.1371/journal.pone.0246318

Grupo Hospitalar Conceição (GHC). Hospital Conceição. Porto Alegre, RS: GHC, 2021. https://www.ghc.com.br/default.asp?idMenu=unidades&idSubMenu=1

Macedo A, Gonçalves N, Febra C. COVID-19 fatality rates in hospitalized patients: systematic review and meta-analysis. Ann Epidemiol. 2021; 57:14-21. https://doi.org/10.1016/j.annepidem.2021.02.012

Grasselli G, Greco M, Zanella A, et al. Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy. JAMA Intern Med;180(10):1345-1355. https://doi.org/10.1001/jamainternmed.2020.3539

Zhong Z, Li H, Zhu J, et al. Clinical characteristics of 2,459 severe or critically ill COVID-19 patients: A meta-analysis. Medicine (Baltimore). 2021; 100(5): e23781. https://doi.org/10.1097/MD.0000000000023781

Hu J, Wang Y. The Clinical Characteristics and Risk Factors of Severe COVID-19. Gerontology. 2021; 67:255–266. https://doi.org/10.1159/000513400

Tan E, Song J, Deane AM, Plummer MP. Global Impact of Coronavirus Disease 2019 Infection Requiring Admission to the ICU: A Systematic Review and Meta-analysis. Chest. 2021;159(2):524-536. https://doi.org/10.1016/j.chest.2020.10.014

Gupta S, Hayek SS, Wang W, et al. Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US. JAMA Intern Med. 2020 1;180(11):1436-1447. https://doi.org/10.1001/jamainternmed.2020.3596

Iman Z, Odish F, Gill I, et al. Older age and comorbidity are independent mortality predictors in a large cohort of 1305 COVID-19 patients in Michigan, United States. J Intern Med. 2020; 288(4):469-476. https://doi.org/10.1111/joim.13119

Marcolino MS, Ziegelmann PK, Souza-Silva MVR, et al. Clinical characteristics and outcomes of patients hospitalized with COVID-19 in Brazil: Results from the Brazilian COVID-19 registry. Int J Infect Dis. 2021 jun; 107:300-310. https://doi.org/10.1016/j.ijid.2021.01.019

Li X, Zhong X, Wang Y, et al. Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis. PLoS One. 2021 may 3;16(5): e0250602. https://doi.org/10.1371/journal.pone.0250602

Li J, Huang DQ, Zou B, et al. Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes. J Med Virol. 2021; 93(3):1449-1458. https://doi.org/10.1002/jmv.26424

Vardavas CI, Nikitara K. COVID-19 and smoking: A systematic review of the evidence. Tobacco induced diseases 20; 18: 1-4. 2020, https://doi.org/10.18332/tid/119324

Olumade TJ, Uzairue LI. Clinical characteristics of 4499 COVID-19 patients in Africa: A meta-analysis. J Med Virol. 2021; 93(5):3055-3061. https://doi.org/10.1002/jmv.26848

Zhou M, Zhang X, Qu J. Coronavirus disease 2019 (COVID-19): a clinical update. Front Med. 2020;14(2):126-135. https://doi.org/10.1007/s11684-020-0767-8

Wiersinga WJ, Rhodes A, Cheng AC, et al. Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020; 324(8):782–793. https://doi.org/10.1001/jama.2020.12839

Nori P, Cowman K, Chen V, et al. Bacterial and fungal coinfections in COVID-19 patients hospitalized during the New York City pandemic surge. Infect. control hosp. epidemiol. 2021; 42(1):84-88. https://doi.org/10.1017/ice.2020.368

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Published

2023-01-17

How to Cite

Almeida , R. dos S. C. de, Klafke, A. ., Garbini , A. F., Carazai , D. dos R., Santos , F. C. dos, Lutkmeier , R., & Baldon, V. (2023). Factors associated with mortality in critically ill patients with COVID-19. Revista De Epidemiologia E Controle De Infecção, 12(4). https://doi.org/10.17058/reci.v12i4.17388

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ORIGINAL ARTICLE