Risk factors associated with worse outcomes in COVID-19: a retrospective study in Saudi Arabia.

Khan, Anas; Althunayyan, Saqer; Alsofayan, Yousef; Alotaibi, Raied; Mubarak, Abdullah; Arafat, Mohammed; Assiri, Abdullah; Jokhdar, Hani

Background The rapid emergence of the novel coronavirus disease 2019 (COVID-19) has resulted in millions of infected patients and hundreds of thousands of deaths worldwide. Health care services delivery is being compromised due to the surge in the number of infected patients during this pandemic. Aims This study aimed to assess the risk factors associated with poor prognosis among COVID-19 patients in Saudi Arabia. Methods This was a multi-centre retrospective cohort study that included all laboratory-confirmed COVID-19 cases with definitive outcomes in Saudi Arabia during March 2020. Demographic, clinical history, comorbidity and outcomes data were retrieved from the National Health Electronic Surveillance Network (HESN) database. We used logistic regression models to calculate crude and adjusted odds ratios (OR) to explore risk factors for critical outcomes (intensive care unit admission or death) among COVID-19 cases. Results We included 648 COVID-19-positive patients with a median age of 34 years. Of these, 11.9% were in the critical group. Risk factors associated with worse outcomes included males (OR=1.92), age >60 years (OR=3.65), cardiac diseases (OR=3.05), chronic respiratory diseases (OR=2.29), and cases with two or more comorbidities (OR=2.57) after adjusting for age and sex; all had significant P-values <0.05. Conclusions Independent risk factors for critical outcomes among COVID-19 cases include old age, males, cardiac patients, chronic respiratory diseases, and the presence of two or more comorbidities. We recommend designing a unique multi-item scale system to prognosticate COVID-19 patients.