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Predictors of Mortality among COVID-19 Patients Admitted to Intensive Care Units: A Single-Center Study in Tehran,
Arash Amini1, Atabak Najafi1, Arezoo Ahmadi1
1Department of Anesthesiology and Critical Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Older age, hypertension, high inflammation, low oxygen, and severe lung disease predict COVID-19 intensive care unit (ICU) mortality. This study identified key factors for predicting coronavirus disease 2019 (COVID-19) patient outcomes in Iranian ICUs.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Epidemiology
Background:
- Iran was an early epicenter for coronavirus disease 2019 (COVID-19).
- Limited data exists on COVID-19 outcomes and mortality predictors in Iranian intensive care units (ICUs).
- This study investigates predictors of ICU mortality in a tertiary referral hospital in Tehran.
Purpose of the Study:
- To identify predictors of mortality among COVID-19 patients admitted to ICUs.
- To contribute data on COVID-19 outcomes in Iran during the delta variant surge.
- To inform risk stratification and potential treatment strategies.
Main Methods:
- Prospective data collection from 290 COVID-19 patients admitted to Sina hospital ICUs (May-December 2021).
- Inclusion of demographic, comorbidity, laboratory (inflammation markers), radiologic (CT scans), and medication data.
- Logistic regression models used to analyze predictors of ICU mortality.
Main Results:
- Mortality rate in the ICU was 64.5% (187 deaths).
- Predictors of mortality included older age, hypertension, elevated inflammatory markers, low oxygen saturation, and extensive lung involvement on CT scans.
- WHO 8-point ordinal scale indicated disease severity as a predictor.
Conclusions:
- Findings align with international literature on COVID-19 mortality predictors.
- Identified factors can aid in predicting mortality risk for COVID-19 patients.
- Results may guide clinical decision-making and treatment approaches in ICUs.
Background:
Iran was one of the first countries to become an epicenter of the coronavirus disease 2019 (COVID-19) epidemic. However, there is a dearth of data on the outcomes of COVID-19 and predictors of death in intensive care units (ICUs) in Iran. We collected extensive data from patients admitted to the ICUs of the one of the tertiary referral hospitals in Tehran, Iran, to investigate the predictors of ICU mortality.
Methods:
The study population included 290 COVID-19 patients who were consecutively admitted to the ICUs of the Sina hospital from May 5, 2021, to December 6, 2021, a period that included the peak of the epidemic of the delta (δ) variant. Demographic data, history of prior chronic diseases, laboratory data (including markers of inflammation), radiologic data, and medication data were collected.
Results:
Of the 290 patients admitted to the ICUs, 187 (64.5%) died and 103 (35.5%) survived. One hundred forty-one (141, 48.6%) were men, and the median age (10th percentile, 90th percentile) was 60 (41, 80). Using logistic regression models, older age, history of hypertension, high levels of inflammatory markers, low oxygen saturation, substantial lung involvement in computed tomography (CT) scans, and gravity of the disease as indicated by the WHO 8-point ordinal scale were primary predictors of mortality at ICU. The use of remdesivir and imatinib was associated with a statistically non-significant reduction in mortality. The use of tocilizumab had almost no effect on mortality.
Conclusion:
The findings are consistent with and add to the currently existing international literature. The findings may be used to predict risk of mortality from COVID-19 and provide some guidance on potential treatments.
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