Independent Predictors of Mortality in ICU Patients with COVID-19

Abstract

Objective: Early identification of Coronavirus disease 2019 (COVID-19) patients at high mortality risk can improve patient care and prevent deaths. To identify prognostic predictors that increase COVID-19 patient mortality risk in the Intensive Care Unit (ICU). Methods: Retrospective analysis of clinical characteristics and serological biomarkers of ICU-COVID-19 patients was performed in a tertiary hospital from 24 March 2020 to 20 December 2020. Analysis was conducted on two groups of study participants: survivors and deceased. Multivariate logistic regression was used to determine mortality risk. In order to determine prognostic predictors, the ANOVA test was used to compare the data of serological biomarkers on the day of patients' admission to the ICU and on the 5th day of follow-up. Results: A total of 335 patients (54.65%) were in the deceased group, and 278 (45.35%) were in the survivors group. A statistically significant difference was found between the deceased and survivor groups regarding mean age (p<0.001). According to multivariate analyses of patients' data, age, oxygen saturation, direct bilirubin, and ionized calcium were independent predictors of mortality (p <0.05). According to this analysis, age (OR=1.035, p=0.002, 95%CI 1.013-1.058), peripheral capillary oxygen saturation (SpO2) (OR=0.912, p<0.001, 95%CI 0,873-0.953), direct bilirubin (OR=6.821, p=0.024, 95%CI 0.282-36.285), ionized calcium (OR=30.524, p=0.035, 95%CI 1.262-738.34) was found that it increased the risk of mortality. In the multivariate logistic regression analysis, it was found that gender, age, and comorbidities had the highest odds ratios in terms of mortality. Conclusion: The study revealed that advanced age, low SpO2, high direct bilirubin, and elevated ionized calcium levels were independent predictors of mortality for COVID-19 patients in the ICU.

Keywords

• COVID-19
• Intensive Care Unit
• Mortality
• Prognostic Predictors

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