Mortality and associated factors in covid19 patients admitted to covid19 ICU in ekakotebe general hospital

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Date

2020-11

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Addis Abeba University

Abstract

Background the world is facing unprecedented health crisis with the pandemic caused by novel coronavirus SARS COVID19 1 .The pathogen is spread by human to human transmission through droplet exposure and contact surface causing minor symptom in majority but critical illness ,bilateral pneumonia and ARDS in minority 2 . The burden of escalating the case number of covid19 is presenting a challenge to management of patients in the intensive care unit. The number of patients with covid19 admitted to ICU is escalating in Ethiopia. Identifying the risk factors among patients in the intensive care unit between the survivors and non survivors, and predicting mortality will have significant impact to determine prognosis and direct resource management. Objective: to identify associated risk factors and mortality of patients with covid19 admitted to ekakotebe intensive care unit. Method: a 7 month retrospective cohort study was employed at ICU of eka kotebe general hospital. . Review of records of all the patients admitted during the period was carried out. Information on socio-demographic characters, characteristic of patient, comorbidities and lab investigations on admission, and outcomes was collected through trained data collectors and the principal investigator by using prepared questioner. Data compiled and analyzed using computer software and presented using tables, graphs and figure Result: During the period of the study 163 critical patients were admitted to covid19 ICU with laboratory confirmed covid19.Most patients were male (68.1%; 95% CI, 61.3%-76.1%]), with a median age of 60 (95% CI, 58-65; IQR, 50-67) years. One hundred fourteen (69.9%; 95% CI, 63.8%-77.8%) had at least 1 comorbidity. Median time from symptom onset to ICU admission was 7 (95% CI, 6.1-8; IQR, 5-11) days. A total of 73 patients were intubated during the study period, 32 (43.8%) were during admission and the others (41(56.1%)) patients were intubated after mean length of stay of 4.47 (95% CI 3.5-5.5) days at ICU. Median duration on mechanical ventilator was 6 (IQR 3-12 95% CI 5-8, range 1-30) days. The median length hospital stay was 16 (IQR 10-23 range 2-48) days. The median length of ICU stay was 7 (IQR 4-12 95% CI 5-8) days. At the time of censoring, a total of 77 patients (49.1% 95% CI 41.7-56.4) transferred from ICU only 3 patients were still in ICU. And a total of 83(50.9%; CI 43.6-59.5) patients has died in ICU. Among comorbidities CLD was significantly associated with mortality with (HR: 4 (95%CI 1.28-12). Elevated liver function (HR: 1.83 95 CI (1.08-3.13 p -0.02) and PH<7.35(HR: 1.8(95% CI 1.05-3)), p value-0.03) during admission were also had significantly associated with mortality. The invasive mechanical ventilator was also significantly associated with mortality (HR: 2.27(2.27 (1.12-4), p <0.02). Conclusion and recommendation: SARS –covid19 has a serious challenge to our health care system in our country Ethiopia and the world. Despite our hospital had lower number of admission during the study period to our ICU, the mortality rate is high 3 . Patients who require IMV had significant association and absolute high mortality rate. We recommend that a prospective study should be undertaken, with higher number of patients, to strengthen the findings of this study.

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Keywords

Mortality , covid19 patients, covid19 ICU

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