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ICU mortality of covid-19 patients - our experience

Radka Čapková, Stanislav Ševela, Hana Petrášková

Vnitrni Lekarstvi

|April 23, 2022

Insights

COVID-19 ICU patients had a 37% mortality rate, higher than pre-pandemic levels. Comorbidities and older age significantly increased mortality risk in severe COVID-19 cases.

Area of Science:

Critical Care Medicine
Infectious Diseases
Epidemiology

Background:

COVID-19 poses a significant threat to critically ill patients.
Understanding patient characteristics and risk factors is crucial for managing ICU outcomes.
Comorbidities are known to influence the severity and prognosis of infectious diseases.

Purpose of the Study:

To characterize COVID-19 patients admitted to the ICU.
To determine the mortality rate among these patients.
To identify comorbidities associated with severe disease and increased mortality.

Main Methods:

A retrospective observational study was conducted in an ICU setting.
Data from 91 adult COVID-19 patients admitted to the ICU were analyzed.
Patient demographics, comorbidities, ventilation support, and outcomes were recorded.

Main Results:

The median age of patients was 67 years, with hypertension and diabetes as the most common comorbidities.
37% of patients experienced mortality, with higher rates observed in older patients and those with multiple comorbidities.
Ventilation support included high flow nasal oxygen (HFNO), non-invasive ventilation (NIV), and invasive mechanical ventilation (IPV), with 40% of patients requiring intubation.

Conclusions:

The overall ICU mortality for COVID-19 patients was 37%, exceeding pre-pandemic rates.
Mortality risk was associated with advanced age and the presence of comorbidities.
Nearly all ICU patients with COVID-19 had at least one significant comorbidity.

Read full analysis

Abstract

Objectives:

To determinate characteristics of covid-19 patients in our ICU, to determinate mortality and presence of comorbidities considered as risk factor for severe course of disease.

Methods:

Retrospective observation study in ICU with 5-8 beds. Population of 91 adults with covid-19 admitted to ICU.

Results:

Median age was 67 years (38-88). Hypertension (56 patients, 61 %) and diabetes (35 patients, 38 %) were the most common comorbidities. 24 patients (26 %) were obese with BMI 30-40, 10 patients (11 %) with BMI > 40. Average SOFA score on admission was 3,5 (1-10). HFNO (high flow nasal oxygen) therapy was the highest ventilation support used in 14 (15 %) patients (while 9 (64 %) of them had limitation of therapy by order D.N.I.), NIV (non-invasive ventilation) in 17 (18 %) patients (9 of them (52 %) had limitation of therapy with order D.N.I.). Conditions of 37 (40 %) patients required intubation and invasive mechanical ventilation. Overall mortality in our cohort was 37 %. Mortality of patients with 2 or more comorbidities was 46 %, mortality of patients without comorbidities was 44 % (in total 4 patients with high age). The highest mortality was in the group of patients 80-90 years (89 %). Mortality in the group of patients younger than 50 years was surprisingly high (27 %), but these were 3 patients in total. Mortality of patients requiring IPV was 43 %.

Conclusion:

Mortality of covid-19 patients in our ICU was 37 % which is much higher than mortality in the same period in 2019 and 2020 before the beginning of pandemic. Mortality increased with higher age. Almost all our patients had at least one of the comorbidities mentioned above.

Keywords:

COVID-19 D.N.I. (do not intubate)age comorbidities high flow nasal oxygen (HFNO) therapy intensive care unit (ICU)invasive mechanical ventilation mortality non-invasive ventilation (NIV)

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