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The Impact of COVID-19 Infection on Patients with Chronic Diseases Admitted to ICU: a Cohort Retrospective Study
Farah Alammari1,2, Batla S Al-Sowayan1,3, Bayan Albdah4,3
1Department of Blood and Cancer Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Insights
COVID-19 significantly impacts patients with cardiovascular diseases (CVD), chronic kidney diseases (CKD), and cancer. CKD patients experienced longer ICU stays, indicating poorer outcomes and highlighting key risk factors for critical care management.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Internal Medicine
Background:
- COVID-19 infection presents significant global morbidity and mortality.
- Understanding disease characteristics in vulnerable populations is crucial for effective management.
- Chronic diseases like CVD, CKD, and cancer are common comorbidities in severe COVID-19 cases.
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of COVID-19 patients with pre-existing cardiovascular diseases (CVD), chronic kidney diseases (CKD), and cancer admitted to the Intensive Care Unit (ICU).
- To identify significant risk factors and guide management strategies for critically ill COVID-19 patients with these chronic conditions.
Main Methods:
- Retrospective study analyzing data from 535 COVID-19 patients admitted to the ICU.
- Collected and analyzed patient symptoms, clinical laboratory findings, medications, length of ICU stay, and outcomes.
- Compared outcomes across patient groups with CVD, CKD, and cancer.
Main Results:
- Overall ICU discharge rate was 80.93%, with a mortality rate of 19.06%.
- Common symptoms included cough, shortness of breath (SOB), and fever.
- Elevated D-dimer, LDH, and inflammatory markers were frequently observed.
- Chronic kidney disease patients exhibited longer ICU stays (13.93 ± 15.87 days), suggesting poorer outcomes compared to CVD and cancer patients.
Conclusions:
- COVID-19 poses significant risks to patients with underlying CVD, CKD, and cancer.
- CKD patients represent a particularly vulnerable group with worse ICU outcomes.
- Identifying these risk factors is vital for prioritizing ICU admission and optimizing treatment for critically ill COVID-19 patients.
Abstract:
The coronavirus disease (COVID-19) infection is causing significant morbidity and mortality rates worldwide. A comprehensive investigation of the disease characteristics, especially among vulnerable disease groups, could help better manage the disease and reduce the pathogen's effect. This retrospective study examined the impact of COVID-19 infection on three groups of patients with chronic diseases. We investigated the clinical characteristics and outcomes of 535 COVID-19 patients with cardiovascular diseases (CVD), chronic kidney diseases (CKD), and Cancer that were admitted to the Intensive Care Unit (ICU). Of the total cases, 433 patients (80.93%) were discharged from the ICU, and 102 patients (19.06%) were declared dead. Patients' symptoms, their clinical laboratory findings, number and type of medications, length of ICU stay, and outcome were collected and analyzed. Most COVID-19 patients included in our study were associated with other comorbidities such as diabetes mellitus, hypertension, and heart disease and failure. Upon ICU admission, the main COVID-19-related symptoms in CVD, CKD, and cancer patients were cough (55.73, 50.42, and 50.5%, respectively), Shortness of Breath (SOB) (59.38, 43.1, and 43.7%, respectively), and fever (41.15%, 48.75%, and 28.2%, respectively). In terms of lab findings, D-dimer, LDH, and inflammatory markers, in particular, were outside the normal range. Treatment options for patients with COVID-19 in ICU were mainly antibiotics, synthetic glucocorticoids, and Low Molecular Weight Heparin (LMWH). Furthermore, CKD patients had a longer ICU stay (13.93 ± 15.87 days) which illustrates the poorer outcome in this group of patients compared with the others. In conclusion, our results highlighted the significant risk factors among COVID-19 patients within the three groups. This can guide physicians in prioritizing ICU admission and help in the management of critically ill patients with COVID-19.
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