Bradycardia and Outcomes in COVID-19 Patients on Remdesivir: A Multicenter Retrospective Study.

Background: Antiviral agents, such as remdesivir, have shown promising results in helping reduce the morbidity and healthcare burden of coronavirus disease 2019 (COVID-19) in hospitalized patients. However, many studies have reported a relationship between remdesivir and bradycardia. Therefore, this study aimed to analyze the relationship between bradycardia and outcomes in patients on remdesivir. Methods: We conducted a retrospective study of 2,935 consecutive COVID-19 patients admitted to seven hospitals in Southern California in the United States between January 2020 and August 2021. First, we did a backward logistic regression to analyze the relationship between remdesivir use and other independent variables. Finally, we did a backward selection Cox multivariate regression analysis on the sub-group of patients who received remdesivir to evaluate the mortality risk in bradycardic patients on remdesivir. Results: The mean age of the study population was 61.5 years; 56% were males, 44% received remdesivir, and 52% developed bradycardia. Our analysis showed that remdesivir was associated with increased odds of bradycardia (odds ratio (OR): 1.9, P < 0.001). Patients that were on remdesivir in our study were sicker patients with increased odds of having elevated C-reactive protein (CRP) (OR: 1.03, P < 0.001), elevated white blood cell (WBC) on admission (OR: 1.06, P < 0.001), and increased length of hospital stay (OR: 1.02, P = 0.002). However, remdesivir was associated with decreased odds of mechanical ventilation (OR: 0.53, P < 0.001). In the sub-group analysis of patients that received remdesivir, bradycardia was associated with reduced mortality risk (hazard ratio (HR): 0.69, P = 0.002). Conclusions: Our study showed that remdesivir was associated with bradycardia in COVID-19 patients. However, it decreased the odds of being on a ventilator, even in patients with increased inflammatory markers on admission. Furthermore, patients on remdesivir that developed bradycardia had no increased risk of death. Clinicians should not withhold remdesivir from patients at risk of developing bradycardia because bradycardia in such patients was not found to worsen the clinical outcome.

Serious Games and Gamification: Health Care Workers' Experience, Attitudes, and Knowledge.

OBJECTIVE: With the rapid advancement of digital technology due to COVID-19, the health care field is embracing the use of digital technologies for learning, which presents an opportunity for teaching methods such as serious games to be developed and improved. Technology offers more options for these educational approaches. The goal of this study was to assess health care workers' experiences, attitudes, and knowledge regarding serious games in training. METHODS: The convenience sample consisted of 223 participants from the specialties of internal medicine and psychiatry who responded to questions regarding sociodemographic data, experience, attitudes, and knowledge regarding serious games. This study used an ordinal regression model to analyze the relationship between knowledge, attitudes, and experiences and the idea or wish to implement serious games. RESULTS: The majority of healthcare workers were not familiar with serious games or gamification. The results show gender and age differences regarding familiarity and willingness to use serious games. With increasing age, the respondents preferred conventional and traditional learning methods to playful teaching elements; younger generations were significantly more motivated than older generations when envisioning using elements of serious games in the future. CONCLUSIONS: The COVID-19 pandemic has encouraged the use of new technologies and digitalization. This study describes positive attitudes toward serious games, mainly in younger people working in health care. Serious games present an opportunity to develop new approaches for postgraduate medical teachings and continuing medical education.

Impact of COVID-19 on Outcomes of Patients Hospitalized With STEMI: A Nationwide Propensity-matched Analysis.

Patients with ST-segment elevation myocardial infarction (STEMI) and concurrent coronavirus disease 2019 (COVID-19) have been reported to have poor outcomes. However, previous studies are small and limited. The National Inpatient Sample database for the year 2020 was queried to identify all adult hospitalizations with a primary diagnosis of STEMI, with and without concurrent COVID-19. A 1:1 propensity score matching was performed. A total of 159,890 hospitalizations with a primary diagnosis of STEMI were identified. Of these, 2210 (1.38%) had concurrent COVID-19. After propensity matching, STEMI patients with concurrent COVID-19 had a significantly higher mortality (17.8% vs 9.1%, OR 1.96, P< 0.001), lower likelihood to receive same-day percutaneous coronary intervention (PCI) (63.6% vs 70.6%, P = 0.019), with a trend towards lower overall PCI (74.9% vs 80.2%, P = 0.057) and significantly lower coronary artery bypass grafting) (3.0% vs 6.8%, P = 0.008) prior to discharge, compared with STEMI patients without COVID-19. The prevalence of cardiogenic shock, need for mechanical circulatory support, extracorporeal membrane oxygenation, cardiac arrest, acute kidney injury (AKI), dialysis, major bleeding and stroke were not significantly different between the groups. COVID-19-positive STEMI patients who received same-day PCI had significantly lower odds of in-hospital mortality (adjusted OR 0.42, 95% CI 0.20-0.85, P = 0.017). STEMI patients with concurrent COVID-19 infection had a significantly higher (almost 2 times) in-hospital mortality, and lower likelihood of receiving same-day PCI, overall (any-day) PCI, and CABG during their admission, compared with STEMI patients without COVID-19.

Impact of COVID-19 on Patients Hospitalized With Deep Vein Thrombosis and/or Pulmonary Embolism: A Nationwide Analysis.

The Coronavirus disease 2019 (COVID-19) infection predisposes patients to develop deep vein thrombosis (DVT) and pulmonary embolism (PE). In this study, we compared the in-hospital outcomes of patients with DVT and/or PE with concurrent COVID-19 infection vs those with concurrent flu infection. The National Inpatient Sample from 2019 to 2020 was analyzed to identify all adult admissions diagnosed with DVT and PE. These patients were then stratified based on whether they had concomitant COVID-19 or flu. We identified 62,895 hospitalizations with the diagnosis of DVT and/or PE with concomitant COVID-19, and 8155 hospitalizations with DVT and/or PE with concomitant flu infection. After 1:1 propensity score match, the incidence of cardiac arrest and inpatient mortality were higher in the COVID-19 group. The incidence of cardiogenic shock was higher in the flu group. Increased age, Hispanic race, diabetes, chronic kidney disease, arrhythmia, liver disease, coagulopathy, and rheumatologic diseases were the independent predictors of mortality in patients with DVT and/or PE with concomitant COVID-19.

Impact of COVID-19 in patients hospitalized with stress cardiomyopathy: A nationwide analysis.

Stress cardiomyopathy was noted to occur at a higher incidence during coronavirus disease of 2019 (COVID-19) pandemic. This database analysis has been done to compare the in-hospital outcomes in patients with stress cardiomyopathy and concurrent COVID-19 infection with those without COVID-19 infection. The National Inpatient Sample database for the year 2020 was queried to identify all admissions diagnosed with stress cardiomyopathy. These patients were then stratified based on whether they had concomitant COVID-19 infection or not. A 1:1 propensity score matching was performed. Multivariate logistic regression analysis was done to identify predictors of mortality. We identified 41,290 hospitalizations for stress cardiomyopathy, including 1665 patients with concurrent diagnosis of COVID-19. The female preponderance was significantly lower in patients with stress cardiomyopathy and COVID-19. Patients with concomitant COVID-19 were more likely to be African American, diabetic and have chronic kidney disease. After propensity matching, the incidence of complications, including acute kidney injury (AKI), AKI requiring dialysis, coagulopathy, sepsis, cardiogenic shock, cases with prolonged intubation of >24 h, requirement of vasopressor and inpatient mortality, were noted to be significantly higher in patients with COVID-19. Concomitant COVID-19 infection was independently associated with worse outcomes and increased mortality in patients hospitalized with stress cardiomyopathy.

Nationwide Analysis of the Outcomes and Mortality of Hospitalized COVID-19 Patients.

INTRODUCTION: The Coronavirus disease 2019 (COVID-19) pandemic has affected people worldwide with the United States (US) with the largest number of reported cases currently. Previous studies in hospitalized COVID-19 patients have been limited by sample size. METHODS: The National Inpatient Sample database which is the largest inpatient database in the US was queried in the year 2020 for the diagnosis of COVID-19 based on ICD-10-CM U07.1 and associated outcomes. Multivariate logistic regression analysis was used to identify predictors of mortality. STATA 16.0 was used for statistical analysis. RESULTS: A weighted total of 1,678,995 hospitalizations for COVID-19 were identified. Median age of admitted patients with COVID-19 was 65 year (51-77) with 47.9% female and 49.2% White. Majority of the patients admitted were >65 years of age (49.3%). Hypertension and diabetes were the most common comorbidities (64.2% and 39.5%, respectively). Overall inpatient mortality was 13.2% and increasing to 55.9% in patients requiring mechanical ventilation. Trend of inpatient mortality was significantly decreasing over the year. Predictors of inpatient mortality included age, male sex, diabetes, chronic kidney disease, heart failure, arrythmia, obesity, and coagulopathy. Despite a lower proportion of patients admitted to hospital with COVID-19, Black, Hispanic, and Native Americans were at an increased adjusted odds of inpatient mortality. Disparity was also noted in income, with low median household income associated with higher risk of mortality. CONCLUSION: In the largest US cohort with >1.6 million hospitalized COVID-19 patients in 2020, overall inpatient mortality was 13.6% with significantly higher mortality in ventilated patients. Significant socioeconomic and racial disparities were present with minorities at higher odds of mortality.

Comparative Study of COVID- 19 Pneumonia in First and Second Waves

[...]COVID-19 wave in India was more severe than the first wave in terms of the number of patients affected as well as the severity of the pneumonia in the involved patients, likely due to continuously mutating variants ofthe virus & lifting up of the restrictions. [1] The diagnosis of this disease depends upon the real-time reverse transcriptase polymerase chain reaction . The CT manifestations of the COVID-19 pneumonia include multifocal ground glass and consolidative opacities in a peripheral distribution with predominantly apicobasal gradient . [6,7] Material and Methods A cross sectional study was conducted among the patients who had documented RT-PCR positive and CT documented COVID-19 pneumonia admitted in Chest Diseases Hospital of GMC, Jammu.

Clinical presentation and outcomes of chronic kidney disease patients with COVID-19 admitted to the intensive care unit of a teaching hospital of Northern India during the third wave of the pandemic: A retrospective study.

Introduction: Chronic kidney disease (CKD) patients have impaired immune status; that's why these patients are prone to develop infection-related complications. The current study compares non-haemodialysis chronic kidney disease and end-stage renal disease (NO-HD-CKD and ESRD, respectively) patient outcomes, the data of which is sparse. Methods: Patients diagnosed with COVID-19 infection through reverse transcriptase polymerase chain reaction (RT-PCR) were retrospectively studied using electronic health records. Patients were divided into three categories: non-chronic kidney disease (NO-CKD), NO-HD-CKD, and ESRD, and the outcome was assessed. Results: Out of 745 patients, 92 (12.34%) had NO-HD-CKD and 31 (4.16%) had ESRD. CKD patients who were not on haemodialysis had higher rates of comorbidities and D-dimer and C-reactive protein (CRP) values compared to ESRD patients. The overall unadjusted mortality rate was found to be 17.44%, and it was 10.45% in case of NO-CKD patients, 58.69% for NO-HD-CKD patients, and 48.39% for ESRD patients. It was observed that patients having NO-HD-CKD had greater odds ratio of overall expiry in comparison to those without CKD in univariate analysis (OR: 1.58; 95% CI: 1.31-1.91). It was not significant in fully adjusted models (OR: 1.11; 95% CI: 0.88-1.40). Conclusions: During the third wave of COVID-19, we found higher mortality rates for cases with NO-HD-CKD and, to a lower extent, ESRD. However, patients with ESRD were observed to have good outcomes in comparison to those with NO-HD-CKD. Primary care physicians are the first point of contact for patients. Hence, it is critical for them to manage and to do proper referral of comorbid patients to higher centres.

COVID-19 vaccination and myocarditis: A review of current literature.

Vaccination for coronavirus disease 2019 (COVID-19) is a critical strategy in controlling the current pandemic of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). After widespread COVID-19 vaccine imple-mentation, isolated case reports about myocarditis as a potential adverse reaction started coming. As of November 12, 2021, Centers for Disease Control and Prevention (CDC) has reported 1793 cases of myocarditis or pericarditis among young people with age 12-29 years, most cases have been reported in the male adolescent age group after the second dose of mRNA COVID-19 vaccines. It is very important to monitor the safety standards and adverse reactions of vaccines to effectively implement the vaccination policies. The CDC and the United States Food and Drug Administration actively monitor vaccine-associated adverse reactions a well-known platform such as Vaccine Adverse Event Reporting System. CDC continues to recommend COVID-19 vaccines and booster doses for eligible individuals (age limit according to the type of vaccine) after careful consideration from risk-benefit assessment and favorable outcomes from vaccination. Mechanisms behind COVID-19 vaccine-induced myocarditis are not clear yet but several possibilities such as molecular mimicry between the spike protein of SARS-CoV-2 and self-antigens, immune response to mRNA, and activation of host immunological system, trigger of the pre-existing dysregulated immunological system have been documented in the literature. Overall, data suggests a good prognosis, especially in young patients. In this review article, we cover currently available data on COVID-19 vaccine-related myocarditis incidence, concerns, possible mechanisms of myocarditis, current treatment, and outcome trends, risk vs benefit assessment of COVID-19 vaccination in this current pandemic.

Predictors of Mortality in COVID-19 Patients in Southern California - Retrospective Multicenter Study.

Introduction The majority of patients infected with coronavirus disease 2019 (COVID-19) recover from the illness after suffering mild to moderate symptoms, while approximately 20% progress to severe or critical disease, which may result in death. Understanding the predictors of severe disease and mortality in COVID-19 patients will help to risk stratify patients and improve clinical decision making. US data to inform this understanding are, however, scarce. We studied predictors of COVID-19 mortality in a cohort of 1,116 hospitalized patients in Southern California in the United States. Methods We conducted a retrospective cohort study of COVID-19 patients admitted at two hospitals in Southern California United States between March 2020 and March 2021. Bivariate and multivariate analyses of the relationship between mortality and other variables such as demographics, comorbidities, and laboratory values were performed, with a p-value of 0.05 considered as significant. Results The analysis involved 1,116 COVID-19 patients, of which 51.5% were males and 48.5% were females. Of the 1,116 patients, 81.6% were whites, 7.2% were blacks, and 11.2% were other races. After adjusting for co-variables, age (p<0.001), admission to intensive care unit (p< 0.001), use of remdesivir (p=0.018), C-reactive protein (CRP) levels (p<0.001), and lactate dehydrogenase (LDH) levels (p=0.039) were independently associated with mortality in our study. Gender, race, body mass index, presence of co-morbidities such as diabetes and hypertension, and use of steroid, statin, calcium channel blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were not associated with mortality in the multivariate analysis. Conclusion In the cohort we studied, admission to intensive care unit was associated with decreased mortality while older age, use of remdesivir, and high levels of CRP and LDH were associated with increased mortality in COVID-19 patients.

COV-DLS: Prediction of COVID-19 from X-Rays Using Enhanced Deep Transfer Learning Techniques.

In this paper, modifications in neoteric architectures such as VGG16, VGG19, ResNet50, and InceptionV3 are proposed for the classification of COVID-19 using chest X-rays. The proposed architectures termed "COV-DLS" consist of two phases: heading model construction and classification. The heading model construction phase utilizes four modified deep learning architectures, namely Modified-VGG16, Modified-VGG19, Modified-ResNet50, and Modified-InceptionV3. An attempt is made to modify these neoteric architectures by incorporating the average pooling and dense layers. The dropout layer is also added to prevent the overfitting problem. Two dense layers with different activation functions are also added. Thereafter, the output of these modified models is applied during the classification phase, when COV-DLS are applied on a COVID-19 chest X-ray image data set. Classification accuracy of 98.61% is achieved by Modified-VGG16, 97.22% by Modified-VGG19, 95.13% by Modified-ResNet50, and 99.31% by Modified-InceptionV3. COV-DLS outperforms existing deep learning models in terms of accuracy and F1-score.

Recent Advances and Future Prospects of Treatment of Pulmonary Hypertension.

Pulmonary hypertension is one of the difficult situations to treat. Complex pathophysiology, association of the multiple comorbidities make clinical scenario challenging. Recently it is being shown that patients who had recovered from coronavirus disease infection, are at risk of developing pulmonary hypertension. Studies on animals have been going on to find out newer treatment options. There are recent advancements in the treatment of pulmonary hypertension. Role of anticoagulation, recombinant fusion proteins, stem cell therapy are emerging as therapeutic options for affected patients. SGLT2 inhibitors have potential to have beneficial effects on pulmonary hypertension. Apart from the medical managements, advanced interventions are also getting popular. In this review article, the authors have discussed pathophysiology, recent advancement of treatments including coronavirus disease patients, and future aspect of managing pulmonary hypertension. We have highlighted treatment options for patients with sleep apnea, interstitial lung disease to discuss the challenges and possible options to manage those patients.

Could anakinra outmatch dexamethasone/tocilizumab in COVID-19?

The hyperinflammatory state leading to an aberrant cytokine production, culminating in acute respiratory distress syndrome, sepsis and multi-organ dysfunction contribute much to the pathophysiologies of severe COVID-19. These severe patients have similar clinical manifestations with patients suffering from certain auto-inflammatory disorders and cytokine storm syndromes. Interestingly, anakinra (blocking both IL-1α and IL-1ß) has shown promises in treating these patients with hyperinflammatory disorders, sepsis with multiorgan failures. Another inflammasome, AIM2, involved in production of IL-1 has also been found to be implicated in COVID-19. IL-1ß, a known procoagulant, causes induction of tissue factor with increasing vascular endothelial permeability loss ensuing in hypercoagulability-one of the cardinal features of the disease. Hence, anakinra a 17kD recombinant human IL-1 receptor antagonist, used widely in Rheumatoid Arthritis treatments might prove efficacious in attenuating the hyperinflammatory state of the disease. Indeed, some of the controlled clinical trials have shown anakinra to effectively decrease mortality and hospital stay. Targeted cytokine blocking are always preferable in comparison with non-specific blocking (steroids) as it is more restrained with the chances of dampening of systemic immune system being much less. Early cell death and neutrophil migration have been one of the pivotal events in COVID-19 pathogenesis. Hence, suPAR levels which measures IL-1α (necroptosis) and S100A8/A9 (neutrophil migration) can perhaps be a good early biomarker predicting the disease progression. Lastly and importantly, as the vaccines are raised against spike protein and the different variants of concern are known to evade the neutralizing antibodies by varying degrees, it will be deserving to assess anakinra, against the variants of concern as an immunomodulatory drug.

COVID-19 Cardiovascular Connection: A Review of Cardiac Manifestations in COVID-19 Infection and Treatment Modalities.

The coronavirus pandemic has crippled healthcare system since its outbreak in 2020, and has led to over 2.6 million deaths worldwide. Clinical manifestations of COVID-19 range from asymptomatic carrier to severe pneumonia, to life-threatening acute respiratory distress syndrome (ARDS). The early efforts of the pandemic surrounded treating the pulmonary component of COVID-19, however, there has been robust data surrounding the cardiac complications associated with the virus. This is suspected to be from a marked inflammatory response as well as direct viral injury. Arrhythmias, acute myocardial injury, myocarditis, cardiomyopathy, thrombosis, and myocardial fibrosis are some of the observed cardiac complications. There have been high morbidity and mortality rates in those affected by cardiac conditions associated with COVID-19. Additionally, there have been documented cases of patients presenting with typical cardiac symptoms who are subsequently discovered to have COVID-19 infection. In those who test positive for COVID-19, clinical awareness of the significant cardiac components of the virus is pertinent to prevent morbidity and mortality. Unfortunately, treatment and preventative measures developed for COVID-19 have been shown to be also be associated with cardiac complications. This is a comprehensive review of the cardiac complications and manifestations of COVID-19 infection in addition to those associated with both treatment and vaccination.

An insight into SARS-CoV-2 structure, pathogenesis, target hunting for drug development and vaccine initiatives.

SARS-CoV-2, the virus responsible for the COVID-19 pandemic, has been confirmed to be a new coronavirus having 79% and 50% similarity with SARS-CoV and MERS-CoV, respectively. For a better understanding of the features of the new virus SARS-CoV-2, we have discussed a possible correlation between some unique features of the genome of SARS-CoV-2 in relation to pathogenesis. We have also reviewed structural druggable viral and host targets for possible clinical application if any, as cases of reinfection and compromised protection have been noticed due to the emergence of new variants with increased infectivity even after vaccination. We have also discussed the types of vaccines that are being developed against SARS-CoV-2. In this review, we have tried to give a brief overview of the fundamental factors of COVID-19 research like basic virology, virus variants and the newly emerging techniques that can be applied to develop advanced treatment strategies for the management of COVID-19 disease.

Comparison of Clinical Characteristics and Outcomes of COVID-19 Between Young and Older Patients: A Multicenter, Retrospective Cohort Study.

Background Outcomes of coronavirus disease 2019 (COVID-19) have been reported to be different in the young and elderly populations. However, previous studies examining these characteristics and differences in outcomes between the two groups had a small sample size. Therefore, in this study, we evaluate the differences between young and elderly patients using a large multicenter dataset. Methodology We conducted a retrospective study of 1,116 consecutive COVID-19 patients admitted to two hospitals in southern California in the United States between March 2020 and March 2021. In this study, we categorized patients into two age groups: less than 65 years and 65 years and above. Finally, Kaplan-Meier and backward selection Cox multivariate regression analyses were done using mortality as the dependent variable. Results Our analysis showed increased survival in patients aged less than 65 years compared to those aged 65 years or above (p < 0.001). Furthermore, in patients aged 65 years and above, age (hazard ratio (HR) = 1.05; p < 0.001), C-reactive protein (CRP) (HR = 1.05; p < 0.001), and bradycardia (HR = 2.1; p < 0.001) were significantly associated with mortality. Similarly, CRP (HR 1.05; p = 0.02) was significantly associated with mortality in patients aged less than 65 years. However, contrary to many studies, being male (HR = 0.46; p = 0.002) was protective against mortality in patients aged less than 65 years. Conclusions Our study showed that the predictors of mortality in COVID-19 patients differed by age group. While age, CRP, and bradycardia were associated with mortality in those aged less than 65 years, only CRP was associated with mortality in those aged 65 years and above.

'Stenting the Lacrimal System in Modified Denker's for Mucormycosis: Really Needed!'-A Longitudinal Study.

Introduction: Recent advances in endoscopic paraphernalia have brought the once intricate anterior lateral wall of maxilla, within reach of the endoscopic surgeon. Endoscopic modified Denker's approach provides another route to reach the indiscernible sites of maxillary & other paranasal sinuses along with PPF (pterygo-palatine fossa)/ITF (infra-temporal fossa) region. This approach has been widely used Pan-India during the Post-Covid Mucormycosis Epidemic, in our country. As this approach mandates sacrifice of nasolacrimal duct, the suspicion in some quarters about post-op fibrosis and eventually obstruction of lacrimal drainage is genuine. Aim: The aim is to understand the legitimate effect of this approach on lacrimal drainage pathway and to determine the need for modification in this approach, like stenting the NLD. Materials and Methods: In total, 100 patients who underwent endoscopic modified Denker's maxillectomy for invasive rhino-orbito-cerebral mucormycosis were included in study. The patency of lacrimal drainage was checked by doing lacrimal sac syringing in each patient. Proportion of patients showing obstruction of lacrimal pathway was calculated. Result: The ratio of lacrimal obstruction was found to be 9%. Hence, endoscopic modified Denker's approach for lesions involving anteroinferior and anterolateral part of maxillary sinus does not cause significant obstruction in the lacrimal drainage pathway.

Predictors of COVID-19 Mortality in Critically Ill ICU Patients: A Multicenter Retrospective Observational Study.

Introduction Coronavirus disease 2019 (COVID-19) is a multisystemic disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and can lead to a broad spectrum of disease severity, from asymptomatic to severe respiratory disease. In addition, the mortality rate is exceedingly high among COVID-19 patients admitted to the ICU. The purpose of this study is to examine the differences between survivors and non-survivors of critically ill COVID-19 patients admitted to the ICU. Method This multicenter retrospective observational study was conducted at two hospitals in Southern California, USA. First, we compared the characteristics of the ICU patients that died and those that survived using the chi-square test for categorical variables and t-test for the continuous variables, with a p-value of 0.05 considered significant. Finally, we did a backward selection Cox multivariate regression analysis using mortality as a dependent variable. Result There were 1,116 patients admitted with COVID-19 during our study period. Of this number, 238 (21.3%) were admitted to the ICU. Among patients admitted to the ICU, 195 (81.9%) died and 43 (18.1%) survived. In the multivariate Cox regression analysis, C-reactive protein (CRP) (HR 1.03, 95% CI 1.003-1.059), tachycardia (HR 3.51, 95% CI 1.83-6.72), and age (HR 1.02, 95% CI 1.01-1.04) were independently associated with mortality. Patients' BMI and comorbidities such as hypertension, diabetes, chronic obstructive pulmonary disease, and chronic kidney disease did not predict mortality. Conclusion Age, elevated CRP, and tachycardia were independent risk factors for mortality in COVID-19 patients admitted to the ICU. It appears that several factors that predict severe diseases in COVID-19 patients, such as BMI and comorbidities, become less important once patients are admitted to the ICU.