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 survived 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 andp<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). Labora-tory 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 con-tribute to reduce ICU admissions and mortality by improving patient management and resource utilization in hospitals.