Clinical pattern, management outcome, and associated factors of patients admitted to COVID-19 ICU center of St. Paul's Hospital Millennium Medical College

Abstract

Background: The coronavirus disease 2019, caused by the recent severe acute respiratory syndrome novel virus, is considered one of the greatest global public health crises by the WHO. It claimed millions of lives globally, with death occurring among populations with certain contributing factors. This study aimed to assess the clinical profile, management outcome, and associated factors of COVID-19-infected patients who were admitted to St. Paul Hospital Millennium Medical College COVID-19 ICU Center.

Methods: Institution-based cross-sectional study was conducted in St. Paul's Hospital Millennium Medical College among patients admitted to the COVID-19 ICU from June 8, 2020, to May 30, 2021. A systematic random sampling technique was applied to select eligible patients’ charts. The data were entered and analyzed using SPSS version 26. Descriptive analysis was used for statistical analysis of baseline data, and regression analysis was used to determine the association between dependent and independent variables. A p-value <0.05 was considered significant.

Results: A total data of 272 patients were analyzed, with a median age of 60.5 years and more than two-thirds, 183(67.3%) being males. Most (75.7%) had a pre-existing comorbid medical condition, and a majority (71.3%) had a COVID-19 disease of critical disease severity. Overall, the in-ICU mortality rate was 64.3%. Multivariable analysis showed that mortality was significantly associated with intubation (AOR: 2.813; 95% CI: 1.176–6.731), pulmonary embolism (AOR: 36.702; 95% CI: 4.062–331.605), Vasopressor usage (AOR: 84.954; 95% CI: 23.413–308.254), Dialysis or RRT (AOR: 4.191; 95% CI: 1.511-11.620) and ARDS (AOR: 21.149; 95% CI: 4.217–106.075) were associated with death among the studied patients.

Conclusion: The most common comorbidities were hypertension, diabetes, and CKD. Moreover, high mortality among ICU-admitted COVID-19 patients was strongly associated with septic shock with vasopressor use, ARDS, Pulmonary embolism, RRT, and intubated patients.