Author/Authors :
Hatami, Hossein Department of Public Health - School of Public Health and Safety and Environmental and Occupational Hazards Control Research Center - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Soleimantabar, Hussein Department of Radiology - School of Medicine - Imam Hossein Hospital - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Ghasemian, Mehrdad Imam Hossein Hospital - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Delbari, Negar School of Public Health and Safety - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Aryannezhad, Shayan School of Public Health and Safety - Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract :
Background: The rapid increase in the spread of COVID-19 and the numbers of infected patients
worldwide has highlighted the need for intensive care unit (ICU) beds and more advanced therapy. This
need is more urgent in resource-constrained settings. The present study aimed to identify the predictors
of ICU admission among hospitalized COVID-19 patients.
Study design: The current study was conducted based on a retrospective cohort design.
Methods: The participants included 665 definite cases of severe acute respiratory syndrome coronavirus
2 (SARS-CoV-2) hospitalized in Imam Hossein Hospital from February 20 to May 14, 2020. The baseline
characteristics of patients were assessed, and multivariate logistic regression analysis was utilized to
determine the significant odds ratio (OR) for ICU admission.
Results: Participants were aged 59.52±16.72 years, and the majority (55.6%) of them were male.
Compared to non-ICU patients (n=547), the ICU patients (n=118) were older, had more baseline
comorbidities, and presented more often with dyspnea, convulsion, loss of consciousness, tachycardia,
tachypnea, and hypoxia, and less often with myalgia. Significant or (95% CI) of ICU admission was
observed for the 60-80 age group (2.42, 95%CI: 1.01; 5.79), ≥80 age group (3.73, 95%CI: 1.44; 9.42),
≥3 comorbidities (2.07, 95%CI: 1.31; 3.80), loss of consciousness (6.70, 95%CI: 2.94, 15.24), tachypnea
(1.79, 95%CI: 1.03, 3.11), and SpO2<90 (5.83, 95%CI: 2.74; 12.4). Abnormal laboratory results were
more common among ICU-admitted patients; in this regard, leukocytosis (4.45, 95%CI: 1.49, 13.31),
lymphopenia (2.39, 95%CI: 1.30; 4.39), elevated creatine phosphokinase (CPK) (1.99, 95%CI: 1.04;
3.83), and increased aspartate aminotransferase (AST) (2.25, 95%CI: 1.18-4.30) had a significant or
of ICU admission. Chest computer tomography (CT) revealed that consolidation (1.82, 95%CI: 1.02,
3.24), pleural effusion (3.19, 95%CI: 1.71, 5.95), and crazy paving pattern (8.36, 95%CI: 1.92, 36.48)
had a significant or of ICU admission.
Conclusion: As evidenced by the obtained results, the predictors of ICU admission were identified
among epidemiological characteristics, presenting symptoms and signs, laboratory tests, and chest CT
findings.
Keywords :
SARS-CoV-2 , COVID-19 , Intensive Care Units , Risk factors , Critical care
