High mortality rates among COVID-19 intensive care patients in Iraq: insights from a retrospective cohort study at Médecins Sans Frontières supported hospital in Baghdad

Frontiers in Public Health

Public Health

Rami Malaeb¹  Amna Haider¹  Klaudia Porten²  Mustafa Hameed³  Gabriel Kabilwa³  Ibrahim Seyni³  Uche Daniel³  Khalid E. Ahmadana⁴  Aurelie Godard⁵  Evgenia Zelikova⁵  Mustafa Abdulateef⁶ 

[1] Department of Epidemiology and Training, Epicentre, Dubai, United Arab Emirates;Department of Epidemiology and Training, Epicentre, Paris, France;Médecins Sans Frontières, Operational Centre Paris, Baghdad, Iraq;Médecins Sans Frontières, Operational Centre Paris, Dubai, United Arab Emirates;Médecins Sans Frontières, Operational Centre Paris, Paris, France;Rusafa Directorate of Health, Baghdad, Iraq;

关键词: ICU outcomes;    COVID-19;    Iraq;    Baghdad;    ICU mortality;    healthcare;    limited resource settings;    humanitarian;   

DOI  :  10.3389/fpubh.2023.1185330

 received in 2023-03-13, accepted in 2023-08-14,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe Coronavirus Disease 2019 (COVID-19) pandemic has highlighted the challenges of the healthcare system in Iraq, which has limited intensive care unit beds, medical personnel, and equipment, contributing to high infection rates and mortality. The main purpose of the study was to describe the clinical characteristics, the length of Intensive Care Unit (ICU) stay, and the mortality outcomes of COVID-19 patients admitted to the ICU during the first wave and two subsequent surges, spanning from September 2020 to October 2021, in addition to identify potential risk factors for ICU mortality.MethodsThis retrospective cohort study analyzed data from COVID-19 patients admitted to the COVID-19 ICU at Al-Kindi Ministry of Health hospital in Baghdad, Iraq, between September 2020 and October 2021.ResultsThe study included 936 COVID-19 patients admitted to the ICU at Al-Kindi Hospital. Results showed a high mortality rate throughout all waves, with 60% of deaths due to respiratory failure. Older age, male gender, pre-existing medical conditions, ICU procedures, and complications were associated with increased odds of ICU mortality. The study also found a decrease in the number of complications and ICU procedures between the first and subsequent waves. There was no significant difference in the length of hospital stay between patients admitted during different waves.ConclusionDespite improvements in critical care practices, the mortality rate did not significantly decrease during the second and third waves of the pandemic. The study highlights the challenges of high mortality rates among critical COVID-19 patients in low-resource settings and the importance of effective data collection to monitor clinical presentations and identify opportunities for improvement in ICU care.

【 授权许可】

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Copyright © 2023 Malaeb, Haider, Abdulateef, Hameed, Daniel, Kabilwa, Seyni, Ahmadana, Zelikova, Porten and Godard.