Identifying Risk Factors For ICU Admission During The Second Wave Of COVID 19 In A Tertiary Care Centre In Western India

ABSTRACT

Background:The substantial morbidity and mortality seen during second wave of coronavirus disease 2019 (COVID-19) pandemic necessitated identifying demographic, clinical and laboratory markers to assist the clinicians in early recognition of severe disease. We aimed to identify new factors or confirm previously identified factors for risk of ICU (Intensive care unit) admission during the second wave of COVID-19 infection. Material And Methods:This retrospective, single-centre study was conducted from April 1 2021-May30 2021. Data on demographic profile, clinical symptoms, and laboratory findings on admission was collected and compared between ICU and non-ICU patients. Result:Total 440 patients were included. Among these, 184(41.8%) needed ICU admission. The mean agewas 52.75±14.46years. 283(64.3%) patients were males. The most common symptoms were fever (70.7%), cough (65.5%), and shortness of breath (54.1%). As seen in previous studies, mean age, leucocyte count, CRP, S. ferritin, LDH, D-Dimer and comorbidities like diabetes mellitus, COPD, obesity were found more commonly in ICU patients as compared to non-ICU patients. (P= 0.0107, 0.0447 and 0.0314 respectively for diabetes, COPD and obesity). Presence of more than one comorbidity was associated with greater ICU admission (ICU vs. Non-ICU 92(50%) vs. 99 (38.7%), p=0.0234).Time from symptom onset to hospitalization was also significantly longer in ICU patients (7.5±1.05 days vs 4.0±1.26 days; p=0.004). Conclusion:The study confirms that COVID patients who need ICU admission have significantly higher mean age, leucocyte count, CRP, S. ferritin, LDH, D-Dimer and comorbidity. In addition, COVID patients in ICU had significantly lower s. albumin levels and late presentation to hospital.