Clinical features and prognostic factors of intensive and non-intensive 1014 COVID-19 patients: an experience cohort from Alahsa, Saudi Arabia

European Journal of Medical Research

Mohammed Y. Alyousef¹  Saad Alhumaid²  Awad Al-Omari³  Zainab Al Alawi⁴  Nourah Al Dossary⁵  Haifa Al-Shammari⁶  Ali M. Al Ghazal⁷  Maher M. Al Mahdi⁷  Jaffar A. Al-Tawfiq⁸  Alyaa Elhazmi⁹  Ahmed Omar^1,10  Ali A. Rabaan^1,11  Khulud Al Salman^1,12  Sarah Y. Alsabati^1,13  Dayas K. Philip^1,14  Abdulsatar H. Al Brahim^1,15  Salamah A. Alomran^1,15  Mossa Alismail^1,16  Mahdi Bu Jubarah^1,16  Hanan Al Shaikh^1,16  Hatim S. Ahmed^1,17  Maitham S. Al Athan^1,17  Abbas Al Mutair^1,18 

[1] Administration of Academic Affairs and Research, Ministry of Health, Alahsa, Saudi Arabia;Administration of Pharmaceutical Care, Alahsa Health Cluster, Ministry of Health, P. O. Box 12944, Rashdiah Street, 31982, Alahsa, Saudi Arabia;College of Medicine, Alfaisal University, Riyadh, Saudi Arabia;Research Center, Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia;Division of Allergy and Immunology, College of Medicine, King Faisal University, Alahsa, Saudi Arabia;General Surgery Department, Alomran General Hospital, Alahsa, Saudi Arabia;Histopathology Department, King Saud Medical City, Riyadh, Saudi Arabia;Infection Prevention and Control Department, Prince Saud Bin Jalawi Hospital, Alahsa, Saudi Arabia;Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia;Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA;Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA;Intensive Care Unit Department, Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia;Internal Medicine Department, Alomran General Hospital, Alahsa, Saudi Arabia;Molecular Diagnostics Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia;Nursing Department, Al Jaber Hospital for Eye, Ear, Nose and Throat, Ministry of Health, Al-Hofuf, Saudi Arabia;Nursing Department, Maternity and Children Hospital, Alahsa, Saudi Arabia;Nursing Education Department, Maternity and Children Hospital, Alahsa, Saudi Arabia;Pharmacy Department, King Fahad Hofuf Hospital, Alahsa, Saudi Arabia;Pharmacy Department, King Faisal General Hospital, Alahsa, Saudi Arabia;Planning and Research Department, Ministry of Health, Alahsa, Saudi Arabia;Research Center, Almoosa Specialist Hospital, Alahsa, Saudi Arabia;School of Nursing, Wollongong University, Wollongong, Australia;College of Nursing, Princess Norah Bint Abdul Rahman University, Riyadh, Saudi Arabia;

关键词: Admission;    Clinical;    Characteristics;    COVID-19;    ICU;    Intensive;    Care;    Critical;    Mortality;    Outcomes;    SARS-CoV-2;    Saudi Arabia;   

DOI  :  10.1186/s40001-021-00517-7

来源: Springer

【 摘 要 】

BackgroundCOVID-19 is a worldwide pandemic and has placed significant demand for acute and critical care services on hospitals in many countries.ObjectivesTo determine the predictors of severe COVID-19 disease requiring admission to an ICU by comparing patients who were ICU admitted to non-ICU groups.MethodsA cohort study was conducted for the laboratory-confirmed COVID-19 patients who were admitted to six Saudi Ministry of Health’s hospitals in Alahsa, between March 1, 2020, and July 30, 2020, by reviewing patient’s medical records retrospectively.ResultsThis cohort included 1014 patients with an overall mean age of 47.2 ± 19.3 years and 582 (57%) were males. A total of 205 (20%) of the hospitalized patients were admitted to the ICU. Hypertension, diabetes and obesity were the most common comorbidities in all study patients (27.2, 19.9, and 9%, respectively). The most prevalent symptoms were cough (47.7%), shortness of breath (35.7%) and fever (34.3%). Compared with non-ICU group, ICU patients had older age (p ≤ 0.0005) and comprised a higher proportion of the current smokers and had higher respiratory rates (p ≤ 0.0005), and more percentage of body temperatures in the range of 37.3–38.0 °C (p ≥ 0.0005); and had more comorbidities including diabetes (p ≤ 0.0005), hypertension (p ≥ 0.0005), obesity (p = 0.048), and sickle cell disease (p = 0.039). There were significant differences between the non-ICU and ICU groups for fever, shortness of breath, cough, fatigue, vomiting, dizziness; elevated white blood cells, neutrophils, alanine aminotransferase and alkaline aminotransferase, lactate dehydrogenase, and ferritin, and decreased hemoglobin; and proportion of abnormal bilateral chest CT images (p < 0.05). Significant differences were also found for multiple treatments (p < 0.05). ICU patients group had a much higher mortality rate than those with non-ICU admission (p ≤ 0.0005).ConclusionIdentifying key clinical characteristics of COVID-19 that predict ICU admission and high mortality can be useful for frontline healthcare providers in making the right clinical decision under time-sensitive and resource-constricted environment.

【 授权许可】

CC BY