A single-centered, retrospective cohort study of critically ill COVID-19 patients: Is the heart at risk?

Abstract

OBJECTIVE The Philippines has the highest COVID-19 mortality rate by country (per million) in South East Asia. We aim to explore predictors of mortality among critically ill COVID-19 patients. METHODS This single-centered, retrospective cohort study included consecutive patients with confirmed COVID-19 infection and acute respiratory distress syndrome requiring mechanical ventilation and intensive care unit (ICU) admission at The Medical City hospital from March 6 to March 31, 2020. Clinical data were obtained from medical records review and compared between survivors and non-survivors. troponin and NT-proBNP not associated with increased mortality. The clinical course and outcomes of critically ill COVID-19 patients during the first month of the outbreak in Metro Manila are similar to reports from other countries. The mortality of our cohort was high at 73%. We report the use of norepinephrine plus vasopressin and UFH for VTE prophylaxis were predictors of increased mortality among critically ill COVID-19 patients. Mean survival time of non-survivors is likely to be 13 days after ICU admission. We report that elevated troponin and NT-proBNP were not associated with increased mortality. Our findings suggest that those patients who eventually died had greater hemodynamic instability and thus required more vasopressor support. We can conclude that critically ill COVID-19 patients who require inotropic support are at increased risk of death. Although we believe our findings may help guide clinical decision making in COVID-19 patients requiring ICU care, caution must be applied when interpreting results presented here in view of our small cohort. The authors have no conflicts of interest to disclose.