Khatib Mohamad Y, Ananthegowda Dore C, Elshafei Moustafa S, El-Zeer Hani, Abdaljawad Wael I, Shaheen Muhsen A, Ibrahim Abdulsalam S, Abujaber Ahmad A, Soliman Ahmed A, Mohamed Ahmed S, Al-Wraidat Mohammad, Ahmed Amna, Nashwan Abdulqadir J, Saad Mohamed O, Butt Adeel A, Al-Maslamani Muna A, Al-Mohammed Ahmed
Department of Medicine, Division of Critical Care Hazm Mebaireek General Hospital, Hamad Medical Corporation Doha Qatar.
Department of Medicine, Division of Critical Care Hamad General Hospital, Hamad Medical Corporation Doha Qatar.
Health Sci Rep. 2022 May 17;5(3):e542. doi: 10.1002/hsr2.542. eCollection 2022 May.
Clinical characteristics and factors associated with mortality in patients admitted to the intensive care unit (ICU) in countries with low case fatality rates (CFR) are unknown. We sought to determine these in a large cohort of critically ill COVID-19 patients in Qatar and explore the early mortality predictors.
We retrospectively studied the clinical characteristics and outcomes in patients admitted to the ICU at the national referral hospital for COVID-19 patients in Qatar. Logistic regression analysis was used to determine factors associated with mortality.
Between March 7 and July 16, 2020, a total of 1079 patients with COVID-19 were admitted to the ICU. The median (IQR) age of patients was 50 (41-59) years. Diabetes (47.3%) and hypertension (42.6%) were the most common comorbidities. In-hospital mortality was 12.6% overall and 25.9% among those requiring mechanical ventilation. Factors independently associated with mortality included older age ([OR]; 2.3 [95% CI; 1.92-2.75] for each 10-year increase in age, < 0.001), chronic kidney disease (OR; 1.9 [95% CI; 1.02-3.54], = 0.04), active malignancy (OR; 6.15 [95% CI; 1.79-21.12], = 0.004), lower platelet count at ICU admission (OR; 1.41 [95% CI; 1.13-1.75] for each 100 × 103/µl decrease, = 0.002), higher neutrophil-to-lymphocyte ratio at admission (OR; 1.01 [95% CI; 1-1.02] for each 1- point increase, = 0.016), higher serum ferritin level at admission (OR; 1.05 [(95% CI; 1.02-1.08] for each 500 µg/L increase, = 0.002), and higher serum bilirubin level at admission (OR; 1.19 [95% CI; 1.04-1.36] for each 10 μmol/L increase, = 0.01).
The mortality rate among critically ill COVID-19 patients is low in Qatar compared to other countries. Older age, chronic kidney disease, active malignancy, higher neutrophil-to-lymphocyte ratios, lower platelet counts, higher serum ferritin levels, and higher serum bilirubin levels are independent predictors of in-hospital mortality.
在病死率较低的国家，重症监护病房（ICU）收治患者的临床特征及与死亡相关的因素尚不明确。我们试图在卡塔尔大量危重症COVID-19患者队列中确定这些因素，并探索早期死亡预测因素。
我们回顾性研究了卡塔尔全国COVID-19患者转诊医院ICU收治患者的临床特征及转归。采用逻辑回归分析确定与死亡相关的因素。
2020年3月7日至7月16日，共有1079例COVID-19患者入住ICU。患者的年龄中位数（四分位间距）为50（41 - 59）岁。糖尿病（47.3%）和高血压（42.6%）是最常见的合并症。总体住院死亡率为12.6%，需要机械通气的患者中为25.9%。与死亡独立相关的因素包括年龄较大（每增加10岁，比值比[OR]为2.3[95%置信区间（CI）：1.92 - 2.75]，P<0.001）、慢性肾脏病（OR为1.9[95%CI：1.02 - 3.54]，P = 0.04）、活动性恶性肿瘤（OR为6.15[95%CI：1.79 - 21.12]，P = 0.004）、ICU入院时血小板计数较低（每降低100×10³/µl，OR为1.41[95%CI：1.13 - 1.75]，P = 0.002）、入院时中性粒细胞与淋巴细胞比值较高（每增加1个单位，OR为1.01[95%CI：1 - 1.02]，P = 0.016）、入院时血清铁蛋白水平较高（每增加500µg/L，OR为1.05[(95%CI：1.02 - 1.08]，P = 0.002）以及入院时血清胆红素水平较高（每增加10μmol/L，OR为1.19[95%CI：1.04 - 1.36]，P = 0.01）。
与其他国家相比，卡塔尔危重症COVID-19患者的死亡率较低。年龄较大、慢性肾脏病、活动性恶性肿瘤、较高的中性粒细胞与淋巴细胞比值、较低的血小板计数、较高的血清铁蛋白水平以及较高的血清胆红素水平是住院死亡率的独立预测因素。
