Predictive factors of mortality in patients with COVID-19 in Guinea: analysis of the first 140 cases admitted to intensive care unit

Donamou, Joseph; Touré, Abdoulaye; Camara, Amadou Yalla; Camara, Djiki; Camara, M’mah Lamine; Traoré, Abdourhamane Dine; Camara, Mariame Mohamed; Bangoura, Almamy; Dramé, Boubacar Atigou; Sossa, Luc Kouessi; Abékan, Jean-Marc Roméo; Edemessi, Axel Irvin; Saliou, Sow Mamadou

INTRODUCTION: the objective was to identify the predictive factors contributing to COVID-related deaths in Intensive Care Unit. METHODS: this was a 4-month (12(th) March to 12(th) July 2020) cross sectional study carried out in the intensive care unit of the COVID treatment center of Donka National Hospital, the only hospital with a COVID intensive care unit in Guinea. RESULTS: during our period of study 140 patients were hospitalized in the COVID intensive care unit and 35 patients died (25%). In univariate analysis, the occurrence of death was associated with: confusional syndrome (p<0.001), time to admission (p<0.001), use of an inotropic or vasopressor (p<0.001), Brescia score ≥ 2 (p=0.004), non-invasive ventilation (p=0.011), stroke (p=0.014), Acute Respiratory Distress Syndrome (ARDS) (p=0.015), male (p=0.021), provenance (p=0.021), acute renal failure (p=0.022), pulmonary embolism (p=0.022), invasive ventilation (p=0.022), and age > 60 years (p=0.047). In multivariate analysis, the factors predictive of mortality were: Acute Respiratory Distress Syndrome (ARDS) (OR= 6.33, 95% CI [1.66-29]; p=0.007), a Brescia score ≥ 2 (OR =5.8, 95% CI [1.7-19.2]; p=0.004) and admission delay (OR =5.6, 95% CI [1.8-17.5]; p=0.003). CONCLUSION: our study shows that the acute respiratory distress syndrome, then the Brescia score ≥ 2, and finally the time to admission to intensive care were all associated with an increased risk of death for patients. These results are different from those reported in Asia, Europe and North America.