Early Predictors of Intensive Care Unit Admission among COVID-19 Patients in Qatar

ABSTRACT

Background Coronavirus disease (COVID-19) is associated with significant morbidity and mortality. This study aimed to explore the early predictors of intensive care unit (ICU) admission and in-hospital mortality among patients diagnosed with COVID-19. Methods This was a case-control study of adult patients with confirmed COVID-19. Cases were defined as patients admitted to ICU during the period February 29 - May 29, 2020. For each case enrolled, one control was matched by age and gender. Results A total of 1560 patients with confirmed COVID-19 were included. Each group included 780 patients with a predominant male gender (89.7%) and a median age of 49 years (interquartile range = 18). Predictors independently associated with ICU admission were cardiovascular disease (CVD) (adjusted odds ratio (aOR)=1.64, 95% confidence interval (CI) 1.16 - 2.32, p=0.005), diabetes (aOR=1.52, 95% CI 1.08 - 2.13, p= 0.016), obesity (aOR=1.46, 95% CI 1.03-2.08, p= 0.034), lymphopenia (aOR=2.69, 95% CI 1.80-4.02, p< 0.001), high aspartate aminotransferase (AST) (aOR= 2.59, 95% CI 1.53-4.36, p< 0.001), high ferritin (aOR=1.96, 95% CI 1.40-2.74, p< 0.001), high C-reactive protein (CRP) (aOR=4.09, 95% CI 2.81-5.96, p< 0.001), and dyspnea (aOR=2.50, 95% CI 1.77-3.54, p< 0.001). Similarly, significant predictors of mortality included CVD (aOR=2.16, 95% CI 1.32- 3.53, p=0.002), diabetes (aOR=1.77, 95% CI 1.07-2.90, p=0.025), cancer (aOR=4.65, 95% CI 1.50-14.42, p= 0.008), lymphopenia (aOR=2.34, 95% CI 1.45-3.78, p= 0.001), and high AST (aOR= 1.89, 95% CI 1.04-3.43, p=0.036). Risk Factors for ICU admission among patients with COVID-19 (N=1560) Conclusion Having CVD, diabetes, lymphopenia, and increased AST were independent predictors for both ICU admission and in-hospital mortality in patients with COVID-19. In addition, obesity, high ferritin, and CRP levels were associated with increased risk of ICU admission, while cancer was strongly associated with in-hospital mortality. Early identification and monitoring of patients at risk is essential in planning the level of care needed to prevent delay in medical intervention. Disclosures Adel Abou-Ali, PharmD, PhD, Astellas Pharma Global Development, Inc. (Employee)