Clinical Features and Outcomes of Critically Ill Patients with Coronavirus Disease 2019 (COVID-19): A Multicenter Cohort Study

Al Sulaiman, Khalid A.; Al Juhani, Ohoud A.; Eljaaly, Khalid; Alharbi, Aisha A.; Al Shabasy, Adel M.; Alsaeedi, Alawi S.; Al Mutairi, Mashael; Badreldin, Hisham A.; Al Harbi, Shmeylan A.; Al Haji, Hussain A.; Al Zumai, Omar I.; Vishwakarma, Ramesh K.; Alkatheri, Abdulmalik

Background Coronavirus disease-19 (COVID-19) manifested by a broad spectrum of symptoms, ranging from asymptomatic manifestations to severe illness and death. The purpose of the study was to extensively describe the clinical features and outcomes in critically ill patients with COVID19 in Saudi Arabia. Method A multi-center, non-interventional, cohort study for all critically ill patients aged 18 years or older who are admitted to intensive care units (ICUs) between March 1st to August 31st, 2020 with an objectively confirmed diagnosis of COVID19. The diagnosis of COVID19 was confirmed by Reverse Transcriptase–Polymerase Chain Reaction (RT-PCR) on nasopharyngeal and/or throat swabs. Multivariate logistic regression and generalized linear regression were used. We considered a P value of<0.05 statistically significant. Results A total of 560 patients met the inclusion criteria. An extensive list of clinical features were associated with higher 30-days ICU mortality rate such as requiring mechanical ventilation (MV) or developing acute kidney injury within 24hours of ICU admission, higher body temperature, white blood cells, blood glucose level, serum creatinine, fibrinogen, procalcitonin, creatine phosphokinase, aspartate aminotransferase and Total iron-binding capacity. The most common complication during ICU stay was respiratory failure that required MV (71.4%), followed by acute kidney injury (AKI) and thrombosis with a proportion of 46.8% and 11.4% respectively. Conclusion Among patients with COVID19 who were admitted to the ICU, several variables were associated with increasing the risk of ICU mortality at 30 days. Respiratory failure that required MV, AKI and thrombosis were the most common complications during ICU stay.