Clinical characteristics and outcomes of critically ill COVID-19 patients in Sfax, Tunisia

• Published in: Acute and critical care Vol. 37; no. 1; pp. 84 - 93
• Main Authors: Bahloul, Mabrouk, Kharrat, Sana, Chtara, Kamilia, Hafdhi, Malek, Turki, Olfa, Baccouche, Najeh, Ammar, Rania, Kallel, Nozha, Hsairi, Majdi, Chakroun-Walha, Olfa, Hamida, Chokri Ben, Chelly, Hedi, Mahfoudh, Khaiereddine Ben, Karoui, Abelhamid, Karray, Hela, Rekik, Noureddine, Bouaziz, Mounir
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Critical Care Medicine 01-02-2022; 대한중환자의학회
• Subjects: covid-19; intensive care unit; Original; prognosis; respiratory distress; 마취과학; COVID-19; intensive care unit; prognosis; respiratory distress
• ISSN: 2586-6052; 2586-6060
• DOI: 10.4266/acc.2021.00129

Africa, like the rest of the world, has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. However, only a few studies covering this subject in Africa have been published.
We conducted a retrospective study of critically ill adult COVID-19 patients-all of whom had a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection- admitted to the intensive care unit (ICU) of Habib Bourguiba University Hospital (Sfax, Tunisia).
A total of 96 patients were admitted into our ICU for respiratory distress due to COVID-19 infection. Mean age was 62.4±12.8 years and median age was 64 years. Mean arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) ratio was 105±60 and ≤300 in all cases but one. Oxygen support was required for all patients (100%) and invasive mechanical ventilation for 38 (40%). Prone positioning was applied in 67 patients (70%). Within the study period, 47 of the 96 patients died (49%). Multivariate analysis showed that the factors associated with poor outcome were the development of acute renal failure (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.75-25.9), the use of mechanical ventilation (OR, 5.8; 95% CI, 1.54-22.0), and serum cholinesterase (SChE) activity lower than 5,000 UI/L (OR, 5.0; 95% CI, 1.34-19).
In this retrospective cohort study of critically ill patients admitted to the ICU in Sfax, Tunisia, for acute respiratory failure following COVID-19 infection, the mortality rate was high. The development of acute renal failure, the use of mechanical ventilation, and SChE activity lower than 5,000 UI/L were associated with a poor outcome.