Factors Associated with Intensive Care Unit Admission and Mortality in COVID-19 Infection during May-August 2020 Period

ABSTRACT

Objective: COVID-19 infection causes severe pneumonia and multi-organ failure in adults, increases morbidity and mortality. Our study aimed to determine the factors affecting intensive care unit admission and mortality in hospitalized COVID-19 patients. Methods: The demographic, clinical, and laboratory data of hospitalized patients due to COVID-19 between May 1, 2020 and August 1, 2020 were evaluated retrospectively. Patients who were admitted to the intensive care unit or died during follow-up were included in the study group, and patients who were followed in the inpatient settings and sur-vived consisted the control group. The data obtained at the time of hospitalization were evaluated statistically. Results: A total of 473 patients were included in the study. The median age of the patients was 53 years (40-68 years), and 269 (56.9%) were male. During the follow-up, 93(19.7%) patients were admitted to the intensive care unit (ICU). Of the 468 patients for whom follow-up data were available, 62(13.2%) patients died. Patients with older age and comorbid diseases had higher ICU admission and mortality rates (p<0.001 and p<0.001). ICU admission rate was higher in patients with cough (p=0.002), myalgia (p=0.016), and dyspnea (p<0.001) during hospital admission. At the same time, dyspnea was more common in patients who died (p<0.001), and myalgia was more common in surviving patients (p=0.020). Laboratory values associated with both ICU admission and mortality were glucose (p<0.001, p<0.001), AST (p<0.001, p<0.001), serum creatinine (p<0.001, p<0.001), direct bilirubin (p<0.001, p=0.009), albumin (p<0.001, p<0.001), CRP (C-reactive protein) (p<0.001, p<0.001), procalcitonin (p<0.001, p<0.001), leukocyte count (p<0.001, p<0.001), lymphocyte count (p<0.001, p<0.001), neutrophil count (p=0.007, p<0.001), hemoglobin (p<0.001, p<0.001), troponin (p<0.001, p<0.001), D-dimer (p<0.001, p<0.001), ferritin (p<0.001, p<0.001), prothrombin time (p<0.001, p<0.001) and INR (international normalized ratio) (p<0.001, p<0.001) levels. Conclusions: Determining the parameters that define high-risk COVID-19 infected patients in the early period can contribute to reduce ICU admissions and mortality by improving patient management and resource utilization in hospitals.