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Analyzing Trends in Demographic, Laboratory, Imaging, and Clinical Outcomes of ICU-Hospitalized COVID-19 Patients
Mohsen Gholinataj Jelodar1,2, Shahab Rafieian3, Azadeh Allah Dini2
1Department of Internal Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Insights
This study identified key risk factors for COVID-19 mortality in ICU patients in Yazd, Iran. Early detection of conditions like diabetes and hypertension can help reduce fatalities.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Pulmonology
Background:
- COVID-19 significantly impacts hospitalization and ICU admission rates globally.
- Patient demographics, comorbidities, and clinical presentation are crucial determinants of COVID-19 outcomes.
- Understanding these factors is vital for managing severe cases.
Purpose of the Study:
- To investigate the clinical and demographic characteristics of COVID-19 patients admitted to intensive care units (ICUs).
- To identify factors associated with increased mortality and intubation rates in these patients.
- To provide insights for improving patient management and outcomes in Iran.
Main Methods:
- A descriptive-analytical cross-sectional study was conducted on 391 COVID-19 ICU patients in Yazd, Iran.
- Data collected included demographic, clinical, laboratory, and high-resolution computed tomography (HRCT) findings.
- Statistical analysis, including multivariate logistic regression, was performed to identify significant predictors of mortality.
Main Results:
- The average patient age was 63.59 years, with 57.3% males. Common comorbidities included hypertension (41.4%) and diabetes mellitus (39.9%).
- Lung involvement on HRCT averaged a score of 14.03, with alveolar consolidation and ground-glass opacity being prevalent.
- Mortality and intubation rates were 38.1% and 38.9%, respectively. Significant risk factors for mortality included diabetes mellitus, hypertension, chronic kidney disease, and neutrophil-to-lymphocyte ratio.
Conclusions:
- Several demographic and clinical factors, including specific comorbidities and lung involvement, significantly influence COVID-19 patient mortality in the ICU.
- Early identification of high-risk individuals and prompt intervention are crucial for mitigating severe disease progression and reducing mortality rates.
- Findings highlight the importance of comprehensive patient assessment and management strategies in critical care settings.
Background:
COVID-19 has led to significant hospitalization and intensive care unit admission rates. The demographic parameters of COVID-19 patients, such as age, underlying illnesses, and clinical symptoms, substantially influence the incidence and mortality of these individuals. The current study examined the clinical and demographic characteristics of COVID-19 intensive care unit (ICU) patients in Yazd, Iran.
Methods:
The descriptive-analytical cross-sectional study was conducted on ICU patients with a positive RT-PCR test for coronavirus, admitted to the ICU in Yazd province, Iran, over 18 months. To this end, demographic, clinical, laboratory, and imaging data were collected. Moreover, patients were divided into good and worse clinical outcome groups based on their clinical outcomes. Subsequently, data analysis was performed at a 95% confidence interval (CI) using SPSS 26 software.
Results:
391 patients with positive PCR were analyzed. The average age of the patients in the study was 63.59 ± 17.76, where 57.3% were male. On the high-resolution computed tomography (HRCT) scan, the mean lung involvement score was 14.03 ± 6.04, where alveolar consolidation (34%) and ground-glass opacity (25.6%) were the most prevalent type of lung involvement. The most common underlying illnesses in the study participants were hypertension (HTN) (41.4%), diabetes mellitus (DM) (39.9%), ischemic heart disease (IHD) (21%), and chronic kidney disease (CKD) (20.7%). In hospitalized patients, the rates of endotracheal intubation and mortality were 38.9% and 38.1%, respectively. Age, DM, HTN, dyslipidemia, CKD, cerebral vascular accident (CVA), cerebral hemorrhage, and cancer were reported to be significantly different between these two groups of patients, indicating an increase in the rate of intubation and mortality among these patients. Furthermore, the multivariate logistic regression analysis revealed that DM, HTN, CKD, CVA, neutrophil-to-lymphocyte ratio (NLR), the percentage of lung involvement, and initial O2 saturation significantly increase the mortality of ICU patients.
Conclusion:
Several features of COVID-19 patients influence the mortality in these individuals. According to the findings, early detection of this disease in people at high risk of death can prevent its progression and lower mortality rates.
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