Determinants of Mortality in Patients Admitted to Intensive Care Unit Due to COVID-19 Pneumonia

Abstract

Objective: Coronavirus Disease-2019 (COVID-2019), which originated in Wuhan, China in December 2019 and became a global pandemic in March 2020, is a viral infectious condition. This study was planned due to the novel character of the virus, unexpected clinical course of the disease as well as due to the relative lack of data on determinants of severe disease. Methods: This retrospective study was carried out with the inclusion of 80 patients admitted to the Intensive Care Unit (ICU), Medical Faculty of Erzincan Binali Yildirim University between 1st April 2020 and 1st October 2020 due to the diagnosis of COVID-19 pneumonia. Demographic, clinical, and laboratory data, as well as treatments complications, length of ICU stay and mortality rate were compared between patients who had survive or not. Results: Of the 80 patients, 18 were died, and 62 were discharged. The mean age was 69.7 ± 14.7 years, with a female to male ratio of approximately 1:2. Systolic blood pressure and mean arterial pressure on admission were significantly lower in non-survivors (p=0.002, and p=0.026, respectively). Also, non-survivors had significantly higher levels of CRP, procalcitonin, D-dimer, urea, LDH, INR, lactate, and neutrophil count and significantly lower lymphocyte counts as compared to survivors. The predictors of mortality were determined as the need for mechanical ventilation, presence of complications, higher CRP and urea levels in a multivariate regression analysis. Conclusion: Early estimation of patients with a high likelihood of severe illness, assessment of the intensive care unit admission, and convenient treatment strategies are important. This is a precious study that detects an early need for ICU admission and close follow-up of patients.