The outcomes of severe COVID-19 pneumonia managed with supportive care in Palestine: an experience from a developing country.

El-Hamshari, Yousef; Hamarshi, Majdi; Nazzal, Zaher; Akkawi, Amna; Saleh, Dana; Abdullah, Ibtesam; Najjar, Mohammed; Rabi, Razan; Ruzzeh, Saad

INTRODUCTION About 14% of COVID-19 patients experience severe symptoms and require hospitalization. Managing these patients could be challenging for limited-resource countries, such as Palestine. This study aimed to evaluate hospitalized severe COVID-19 patients' treatment outcomes managed with supportive care and steroids. METHODOLOGY This was a single-center observational retrospective cohort study that enrolled COVID-19 patients admitted to the "Martyrs medical military complex- COVID Hospital" in Palestine. The managing physicians manually collected data through chart reviews, including patients' characteristics, complications, outcomes, and different management modalities. Continuous and categorical variables between those who were discharged alive and who died were compared using t-test and Chi-squares test, respectively. RESULTS Overall, 334 patients were included in this study. Median (IQR) age was 62(11) years, 49.1% were males, and 29.6% were ICU status patients. The median (IQR) PaO2/FiO2 ratio was 76 (67), and 67.6% of these patients had moderate to severe acute respiratory distress syndrome, and 4.8% of the patients received invasive mechanical ventilation. Most of the patients (78.7%) had at least one comorbidity, and 18.3% developed at least one complication. The overall mortality was 12.3% (95% CI 8.9-16.2%), and the median (IQR) length of hospital stay was 11 (8) days. Age (aOR 1.05, p = 0.08), smoking (aOR 4.12, p = 0.019), IMV (aOR 27.4, p < 0.001) and PaO2/FiO2 ratio (aOR 1.03, p < 0.001) were found to predict higher mortality. CONCLUSIONS Supportive care for patients with severe COVID-19 pneumonia in a Palestinian hospital with limited resources was associated with in-hospital mortality of 12.3%.