RESUMO
BACKGROUND: Coronavirus disease 2019 (COVID-19) infections may have been associated with secondary infection. Community-acquired or hospital-acquired such infections affect clinical outcomes. We performed a retrospective study to evaluate the impact of these infections on clinical outcomes. METHODS: This was a retrospective analysis of all consecutive patients with COVID-19 admitted to the intensive care unit (ICU) of Dubai hospital. RESULTS: Patients with secondary non-viral infections (SNIs) have higher mortality than patients without SNIs (57.3% vs. 43.7%, p=0.037). Patients with SNIs had more days on mechanical ventilation (MV) 19(11-27) vs. 5(2-10) p<0.001, more LOSICU 22 (15-33) vs. 7 (2-11) p<0.001, and more length of stay in hospital (LOSH) 28 (18-45) vs. 11.5 (6-19), p<0.001. Multiple logistic regression analyses showed that SNIs do not predict mortality. Linear logistic regression analysis showed patients with SNIs have increased length of stay in ICUs (LOSICUs), length of stay in hospitals (LOSHs), and prolonged needs for MV. CONCLUSION: SNIs are high in patients admitted to ICU for COVID-19 acute respiratory distress syndrome (ARDS). Although they do not impact mortality, they prolong the need for MV, LOSICU, and LOSH.
RESUMO
INTRODUCTION: COVID-19 has caused 4 million deaths as of 24 August 2021. A significant number of patients were admitted to undesignated ICU areas before transfer to a desig-nated ICU owing to the unavailability of ICU beds. We aim to compare the mortality and length of stay of patients in these 2 areas. MATERIAL AND METHODS: We retrospectively studied all critically ill patients with COVID-19 pneumonia who were admitted to Dubai hospital between 1 January 2020 and 30 June 2020. Patients who transferred to wards other than designated ICU constitute cases, while those who were admitted directly to designated ICUs constitute controls. The demographics, clinical parameters, and treatment profile of these patients were recorded and compared. Mortality and length of stay were calculated. RESULTS: The sample includes 239 subjects (admitted to an undesignated ICU ward [n = 107] and directly admitted to a designated ICU ward [n = 132]). Patients admitted to an undesignated ICU had extra transfers between wards and had more days on MV (median [IQR] 18 (19) vs. 11 (14); P = 0.001), greater length of stay in the ICU (median [IQR]) 21.5 (19) vs. 15 (14); P = 0.001), and greater length of stay in hospital (median [IQR] 32 (28) vs. 21 (26); P = 0.001). Multiple logistic regression analysis showed that patients treated at an undesignated ICU have better survival (odds of death for patients cared for at an undesignated ICU was 0.347 with CI 0.178-0.676; P = 0.002). Multiple linear regression analysis also showed that patients treated at an undesignated ICU had longer stay - 4.2 days, CI 1.3-7.13, P = 0.004). CONCLUSIONS: Admission to an undesignated ICU impacts mortality and length of ICU and hospital stay.
