Evaluation of Clinical Features and Outcomes of Patients with Coronavirus (COVID-19) Admitted to ICU in Southeastern Iran in 2020

Abstract

Background: Coronavirus, coronavirus disease 2019 (COVID-19), in humans, mainly causes respiratory and gastrointestinal manifestations that can range from a simple cold to severe clinical symptoms or death. On the other hand, COVID-19 patients’ hospitalization in the intensive care unit (ICU) have serious problems, which can affect their mortality; therefore, the awareness of these problems has a main role in decision-making in the early stages. Objectives: This study aimed to evaluate the clinical features and outcomes of patients with COVID-19 admitted to the ICU. Methods: This cross-sectional (descriptive-analytical) study was conducted on patients with COVID-19 pneumonia admitted to the ICU of Valiasr Hospital, Birjand, Iran, in 2020. A total of 111 patients, including 51 female and 63 male subjects, were enrolled in this study using convenience sampling. Demographic data, comorbidities, signs and symptoms, radiological findings, supportive methods of oxygen therapy, and clinical outcomes were collected using a checklist and compared between two groups (i.e., survivors and nonsurvivors). Results: Among 111 patients (including 59 nonsurvivors and 52 survivors), the numbers of mortalities within the age ranges of ≥ 75 and ≤ 44 years were the highest and lowest, respectively. In the survived patients, hypertension (50.8%), diabetes mellitus (47.5%), heart disease (44.1%), and chronic obstructive lung disease (23.7%) were the most common comorbidities. Moreover, dyspnea (81.1%), fever and chills (73%), cough (64.9%), muscle pain (45%), and weakness, and lethargy (42.3%) were the most common symptoms of the patients. Based on the comparison of survived and nonsurvived groups, diarrhea (P < 0.001), sore throat (P < 0.001), nausea (P < 0.001), and vomiting (P < 0.0001) were significantly higher in the group of survived patients. Among the radiological findings (i.e., chest X-ray and high-resolution computed tomography), bronchoalveolar markings (P = 0.05) and pleural effusion (P = 0.02) were higher in the nonsurvived patients. The average Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 16 was reported with a higher mortality rate. Conclusions: Risk factors, including dyspnea, older age, comorbidities, and high APACHE II score, could increase the risk of poor clinical outcomes and help identify ill patients with a poor prognosis at the beginning of ICU admission.