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CC BY-NC-ND 4.0 · Ibnosina Journal of Medicine and Biomedical Sciences 2021; 13(03): 127-135
DOI: 10.4103/ijmbs.ijmbs_48_21
Original Article

Determinants of intensive care unit admission of hospitalized patients with COVID-19 in Saudi Arabia: An analytic retrospective cohort

Sulafa Alqutub
Department of Family and Community Medicine, University of Jeddah, Jeddah
,
Wedad Albalawi
1   University of Tabuk, Tabuk
,
Nermeen Alrajhi
2   King Saud Bin Abdulaziz University For Health Sciences, Riyadh, Saudi Arabia
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Background: In March 2020, Saudi Arabia (KSA) experienced a coronavirus disease 2019 (COVID-19) outbreak. The mitigation strategy aimed to reduce both the impact on vulnerable groups and the risk of admission to the intensive care unit (ICU). Risk factors, such as sequential organ failure, comorbidities, ventilation, and mortality, have not been described in different settings of care. Materials and Methods: A multicenter, retrospective chart review of 220 adults with COVID-19 admitted to the ICU included demographics and ICU admission factors (e.g., quick sequential organ failure assessment (qSOFA) score, ventilator status, comorbidities, days from laboratory confirmation to ICU admission, and days from hospitalization to ICU admission). Regression was utilized to identify predictors of need for mechanical ventilation (MV) and mortality in ICU patients. Results: ICU admission, COVID-19 hospital mortality, and ventilator-associated mortality rates were 26.5%, 44%, and 30.5%, respectively. The mean patients' age was 30 years. Across four cities, Jeddah patients were at the highest risk of MV (<0.001). Within the 1st day of hospitalization, without lymphocytopenia, non-Saudi patients with a qSOFA score of 2 and 3 were at the highest risk of ventilation (odds ratio [OR], 3.9; 95% confidence interval [CI], 1.72–8.66; OR, 11.4; 95% CI, 2.35–55.47; and OR, 6.1; 95% CI, 1.0–37.33, respectively). Moreover, within the same period of hospital stay, mechanically-ventilated patients with a qSOFA score of 3 who received antiviral medications were significantly at the higher risk of death (OR, 2.8.4; 95% CI, 1.44–5.64; OR, 13.1; 95% CI, 1.23–39.68; and OR, 2.2; 95% CI, 1.14–4.14, respectively). Conclusions: The 1st day of hospitalization, along with an assessment of the dyspnea status using the qSOFA score, is the window of opportunity for minimizing ICU admission risk. Neither lymphocytopenia nor comorbidities are associated with the risk of mechanical ventilation. Factors were also discussed. Reviews are needed on the indications for the use of antiviral agents, intubation, and ventilation in hospitalized patients.

Key-words:

COVID-19 - death - intensive care unit admission - Saudi Arabia - quick sequential organ failure assessment - ventilation

Financial support and sponsorship

Nil.




Publication History

Received: 27 June 2021

Accepted: 30 July 2021

Article published online:
14 July 2022

© 2021. The Libyan Authority of Scientific Research and Technologyand the Libyan Biotechnology Research Center. All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License,permitting copying and reproductionso long as the original work is given appropriate credit. Contents may not be used for commercial purposes, oradapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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