Aryal Dipsikha, Pokharel Paras Kumar, Ghimire Anup, Khanal Vijay Kumar, Gurung Gyanu Nepal, Chalise Bimal Sharma, Neupane Sudikshya, Basnet Shikha
B.P Koirala Institute of Health Sciences, School of Public Health and Community Medicine, Dharan, Nepal.
Sukraraj Tropical and Infectious Disease Hospital, Teku, Nepal.
PLOS Glob Public Health. 2024 Mar 21;4(3):e0002516. doi: 10.1371/journal.pgph.0002516. eCollection 2024.
The clinical features of COVID-19 are vary widely, ranging from asymptomatic states or mild upper respiratory tract infections to severe pneumonia. Previous studies have shown that 20.0% of COVID-19 patients are hospitalized, out of which 10.0-20.0% are admitted to the Intensive Care Unit. The present study aims to assess predictors associated with COVID-19 leading to Intensive Care Unit admission among reverse transcriptase- polymerase chain reaction (RT-PCR) positive patients in Sukraraj Tropical and infectious disease hospital, Nepal. A case-control study was conducted from June 2022 to July 2022 among patients admitted to Sukraraj Tropical and Infectious Disease Hospital. A hospital-based age (± 2 years) and sex-matched case-control study design were adopted in which ICU admitted (case group, n = 33) and general ward admitted (control group, n = 66) were included. Data were collected using a structured questionnaire comprising of socio-demographic, clinical, and preventive predictors. Data were analyzed using the Statistical Package for Social Science version 11.5. The Chi-square test and conditional logistic regression to determine the predictors associated with ICU admission. High blood pressure, high C-reactive protein and poor application of preventive practices were found to be the predictors of ICU admission. Conditional logistics regression analyses revealed that independent risk factors associated with ICU admission were elevated blood pressure (AOR = 2.22; 95% CI 1.05-4.71, p = 0.015) and abnormal C-Reactive Protein (AOR = 2.92; 95% CI 1.24-6.84, p = 0.012) at the time of hospital admission were more likely to get admitted to ICU. Likewise, patients with poor preventive practice (AOR = 3.34; 95% CI 1.19-9.31, p = 0.02) more likely to get admitted to ICU than patient with good preventive practices.These research findings hold potential significance for facilitating early triage and risk assessment in COVID-19 patients.
新型冠状病毒肺炎（COVID-19）的临床特征差异很大，从无症状状态或轻度上呼吸道感染到严重肺炎不等。先前的研究表明，20.0%的COVID-19患者需要住院治疗，其中10.0%-20.0%的患者被收入重症监护病房。本研究旨在评估尼泊尔苏克拉拉杰热带病和传染病医院中，逆转录酶-聚合酶链反应（RT-PCR）呈阳性的患者中，与COVID-19导致重症监护病房收治相关的预测因素。2022年6月至2022年7月，在苏克拉拉杰热带病和传染病医院收治的患者中进行了一项病例对照研究。采用了基于医院的年龄（±2岁）和性别匹配的病例对照研究设计，其中包括收入重症监护病房的患者（病例组，n = 33）和收入普通病房的患者（对照组，n = 66）。使用一份包含社会人口统计学、临床和预防预测因素的结构化问卷收集数据。使用社会科学统计软件包第11.5版进行数据分析。采用卡方检验和条件逻辑回归来确定与重症监护病房收治相关的预测因素。发现高血压、高C反应蛋白和预防措施应用不佳是重症监护病房收治的预测因素。条件逻辑回归分析显示，与重症监护病房收治相关的独立危险因素是入院时血压升高（比值比[AOR]=2.22；95%置信区间[CI]1.05-4.71，p = 0.015）和C反应蛋白异常（AOR = 2.92；95%CI 1.24-6.84，p = 0.012）患者更有可能被收入重症监护病房。同样，预防措施不佳的患者（AOR = 3.34；95%CI 1.19-9.31，p = 0.02）比预防措施良好的患者更有可能被收入重症监护病房。这些研究结果对于促进COVID-19患者的早期分诊和风险评估具有潜在意义。
