Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.
Int J Infect Dis. 2021 Apr;105:180-187. doi: 10.1016/j.ijid.2021.02.037. Epub 2021 Feb 15.
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 COVID-19 in Saudi Arabia.
This was a multicenter, non-interventional cohort study for all critically ill patients aged 18 years or older, admitted to intensive care units (ICUs) between March 1 to August 31, 2020, with an objectively confirmed diagnosis of COVID-19. The diagnosis of COVID-19 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.
A total of 560 patients met the inclusion criteria. An extensive list of clinical features was associated with higher 30-day ICU mortality rates, such as requiring mechanical ventilation (MV) or developing acute kidney injury within 24 hours 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. During ICU stay, the most common complication 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.
Among patients with COVID-19 who were admitted to the ICU, several variables were associated with an increased risk of ICU mortality at 30 days. Respiratory failure that required MV, AKI, and thrombosis were the most common complications during ICU stay.
新型冠状病毒病-19（COVID-19）表现出广泛的症状谱，从无症状表现到重症和死亡。本研究的目的是广泛描述沙特阿拉伯重症 COVID-19 患者的临床特征和结局。
这是一项多中心、非干预性队列研究，纳入了 2020 年 3 月 1 日至 8 月 31 日期间入住重症监护病房（ICU）的年龄在 18 岁或以上、有客观确诊 COVID-19 的所有重症患者。COVID-19 的诊断通过鼻咽和/或咽喉拭子的逆转录-聚合酶链反应（RT-PCR）确认。采用多变量逻辑回归和广义线性回归。我们认为 P 值<0.05 具有统计学意义。
共有 560 名患者符合纳入标准。广泛的临床特征与较高的 30 天 ICU 死亡率相关，例如需要机械通气（MV）或在入住 ICU 24 小时内发生急性肾损伤，体温较高，白细胞、血糖水平、血清肌酐、纤维蛋白原、降钙素原、肌酸磷酸激酶、天门冬氨酸氨基转移酶和总铁结合能力。在 ICU 期间，最常见的并发症是需要 MV 的呼吸衰竭（71.4%），其次是急性肾损伤（AKI）和血栓形成，比例分别为 46.8%和 11.4%。
在入住 ICU 的 COVID-19 患者中，几个变量与 30 天 ICU 死亡率增加相关。需要 MV 的呼吸衰竭、AKI 和血栓形成是 ICU 期间最常见的并发症。
