Factors associated with poor outcomes among hospitalized patients with COVID-19: Experience from a MERS-CoV referral hospital


Posted: 2021-10-09 19:00:00
Background: Coronavirus disease 2019 (COVID-19) has resulted in millions of deaths, including more than 6000 deaths in the Kingdom of Saudi Arabia (KSA). Identifying key predictors of intensive care unit (ICU) admission and mortality among infected cases would help in identifying individuals at risk to optimize their care. We aimed to determine factors of poor outcomes in hospitalized patients with COVID-19 in a large academic hospital in Riyadh, KSA that serves as a Middle East Respiratory Syndrome coronavirus (MERS-CoV) referral center. Methods: This is a single-center retrospective cohort study of hospitalized patients between March 15 and August 31, 2020. The study was conducted at King Saud University Medical City (KSUMC). COVID-19 infection was confirmed using real-time reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-COV-2. Demographic data, clinical characteristics, laboratory, radiological features, and length of hospital stay were obtained. Poor outcomes were, admission to ICU, need for invasive mechanical ventilation (IMV), and in-hospital all-cause mortality. Results: Out of 16,947 individuals tested in KSUMC, 3480 (20.5%) tested positive for SARS-CoV-2 and of those 743 patients (21%) were hospitalized. There were 62% males, 77% were younger than 65 years. Of all cases, 204 patients (28%) required ICU admission, 104 (14%) required IMV, and 117 (16%) died in hospital. In bivariate analysis, multiple factors were associated with mortality among COVID-19 patients. Further multivariate analysis revealed the following factors were associated with mortality: respiratory rate more than 24/min and systolic blood pressure <90 mmHg in the first 24h of presentation, lymphocyte count <1 × 109/L and aspartate transaminase level >37 units/L in the first 48 h of presentation, while a RT-PCR cycle threshold (Ct) value ≤24 was a predictor for IMV. Conclusion: Variable factors were identified as predictors of different outcomes among COVID-19 patients. The only predictor of IMV was a low initial Ct values of SARS-CoV-2 PCR. The presence of tachypnea, hypotension, lymphopenia, and elevated AST in the first 48h of presentation were independently associated with mortality. This study provides possible independent predictors of mortality and invasive mechanical ventilation. The data may be helpful in the early identification of high-risk COVID-19 patients in areas endemic with MERS-CoV. Keywords: COVID-19; ICU; Invasive mechanical ventilation; Risk factors.

参考サイト PubMed: covid-19



バイオクイックニュース日本語版:COVID-19特集

バイオクイックニュース日本語版
3月 27, 2020 バイオアソシエイツ

COVID-19治験ワクチンのNIH臨床試験が始まる。ワクチンはウイルスのスパイクタンパク質をコードするmRNA。

シアナのカイザーパーマネンテワシントン健康研究所(KPWHRI)で、コロナウイルス2019(COVID-19)を予防するために設計された治験ワクチンを評価する第1相臨床試験が始った。国立衛生研究所の一部である国立アレルギー感染症研究所(NIAID)が試験に資金を提供している。KPWHRIはNIAIDの感染症臨床研究コンソーシアムの一部だ。このオープンラベル試験では、18歳から55歳までのシアトルを拠点とする45人の健康な成人ボランティアが約6週間に渡り協力する。2020年3月16日に治験ワクチンを最初の参加者に接種…

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