Predictive factors of mechanical ventilation among critically ill adults with COVID-19

ABSTRACT

Introduction: Acute respiratory failure is the main indication for ICU admission in COVID-19 patients. Most of these patients will require invasive mechanical ventilation (IMV). Aim(s) Identify predictive factors for IMV in Tunisian patients with COVID19 hospitalized in intensive care unit (ICU). Method(s) Cross sectional comparative study conducted in Rabta hospital in Tunis, Tunisia from January 2021 and December 2021. Patients with laboratory confirmed COVID-19 admitted in ICU department were enrolled. Clinical, biological and radiological features of all patients were assessed. Patients requiring MV (G1) and those no (G2) were compared. Result(s) A total of 95 patients were included (61 in G1;34 in G2). There was no significant difference between the 2 groups regarding to age or gender. However, comorbidities such as dyslipidemia, stroke and hypertension were more frequent in G1. Among symptoms, anosmia and confusion were predictive for IMV. Patients with anosmia and confusion had respectively 45% and 25% higher risk for IMV. C-reactive protein (CRP) level (95% in G1 VS 89% in G2;p=0.003), D-dimer rate (86.5% in G1 VS 60% in G2;p=0.008) and severe radiological extension (>50%) (64% in G1 VS 35% in G2;p=0.08) were significantly higher in G1. Conclusion(s) Among ICU admitted patients, comorbidities, neurological symptoms, elevated rate of D-dimer and CRP and important radiological damage are the main risk factors for requiring IMV.