Predictors of mortality and morbidity in critically ill COVID‐19 patients: An experience from a low mortality country

Background and Aims Clinical characteristics and factors associated with mortality in patients admitted to the intensive care unit (ICU) in countries with low case fatality rates (CFR) are unknown. We sought to determine these in a large cohort of critically ill COVID‐19 patients in Qatar and explor...

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Published in:	Health science reports Vol. 5; no. 3; pp. e542 - n/a
Main Authors:	Khatib, Mohamad Y., Ananthegowda, Dore C., Elshafei, Moustafa S., El‐Zeer, Hani, Abdaljawad, Wael I., Shaheen, Muhsen A., Ibrahim, Abdulsalam S., Abujaber, Ahmad A., Soliman, Ahmed A., Mohamed, Ahmed S., Al‐Wraidat, Mohammad, Ahmed, Amna, Nashwan, Abdulqadir J., Saad, Mohamed O., Butt, Adeel A., Al‐Maslamani, Muna A., Al‐Mohammed, Ahmed
Format:	Journal Article
Language:	English
Published:	United States John Wiley & Sons, Inc 01-05-2022 John Wiley and Sons Inc
Subjects:	ARDS Body mass index Coronaviruses COVID-19 intensive care Mortality Original Research Qatar SARS‐CoV‐2 Severe acute respiratory syndrome coronavirus 2 Qatar mortality COVID‐19 intensive care SARS‐CoV‐2 Qatar ARDS
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Summary:	Background and Aims Clinical characteristics and factors associated with mortality in patients admitted to the intensive care unit (ICU) in countries with low case fatality rates (CFR) are unknown. We sought to determine these in a large cohort of critically ill COVID‐19 patients in Qatar and explore the early mortality predictors. Methods We retrospectively studied the clinical characteristics and outcomes in patients admitted to the ICU at the national referral hospital for COVID‐19 patients in Qatar. Logistic regression analysis was used to determine factors associated with mortality. Results Between March 7 and July 16, 2020, a total of 1079 patients with COVID‐19 were admitted to the ICU. The median (IQR) age of patients was 50 (41–59) years. Diabetes (47.3%) and hypertension (42.6%) were the most common comorbidities. In‐hospital mortality was 12.6% overall and 25.9% among those requiring mechanical ventilation. Factors independently associated with mortality included older age ([OR]; 2.3 [95% CI; 1.92–2.75] for each 10‐year increase in age, p < 0.001), chronic kidney disease (OR; 1.9 [95% CI; 1.02–3.54], p = 0.04), active malignancy (OR; 6.15 [95% CI; 1.79–21.12], p = 0.004), lower platelet count at ICU admission (OR; 1.41 [95% CI; 1.13–1.75] for each 100 × 103/µl decrease, p = 0.002), higher neutrophil‐to‐lymphocyte ratio at admission (OR; 1.01 [95% CI; 1–1.02] for each 1‐ point increase, p = 0.016), higher serum ferritin level at admission (OR; 1.05 [(95% CI; 1.02–1.08] for each 500 µg/L increase, p = 0.002), and higher serum bilirubin level at admission (OR; 1.19 [95% CI; 1.04–1.36] for each 10 μmol/L increase, p = 0.01). Conclusions The mortality rate among critically ill COVID‐19 patients is low in Qatar compared to other countries. Older age, chronic kidney disease, active malignancy, higher neutrophil‐to‐lymphocyte ratios, lower platelet counts, higher serum ferritin levels, and higher serum bilirubin levels are independent predictors of in‐hospital mortality.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2398-8835 2398-8835
DOI:	10.1002/hsr2.542