Clinical Characteristics and Outcome of Critically ill SARS-CoV-2 Patients Admitted to Intensive Care Unit of a Tertiary Care Hospital in North India: A Retrospective StudyCorrespondence Address :
Dr. Rajeev Kumar Nishad,
C/o Dr. Reetu Verma, S.N. Hospital Campus, Firozabad, Uttar Pradesh, India.
Introduction: World Health Organisation (WHO) declared the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak a pandemic on 11th March 2020, due to the constantly increasing number of cases outside China. Previously, India had global record of highest single day spike of Coronavirus Disease19 (COVID-19) cases, with 97,894 cases on 17th September 2020.
Aim: To find out the demographic and clinical characteristics of critically ill patients of SARS-CoV-2 and comparing the outcomes of patients admitted in COVID dedicated Intensive Care Unit (ICU) with and without co-morbidities and also in different age groups and sex.
Materials and Methods: This retrospective study from July 2020 to December 2020 was a single centre observational experience of management of COVID-19 patients at COVID dedicated ICU in Firozabad, India. The following data were recorded: age, sex, comorbidities and mode of oxygen delivery (invasive mechanical ventilation, non-invasive mechanical ventilation, high flow nasal canula). Chi-square test was used to compare the outcomes of patients admitted in COVID dedicated ICU with and without comorbidities and also in different age groups and sex.
Results: In this study, the data of 120 severely ill COVID-19 patients were reviewed. The mean age of patients were (58Â±15.29) years and male to female ratio was 3:1. At least one co-morbid condition was reported in 53.3% of patients-most common being hypertension (36.6%) followed by diabetes mellitus 2 (20%), Chronic Obstructive Pulmonary Disease (COPD) (15%) and then followed by cardiovascular diseases, renal and liver diseases. All patients admitted to COVID ICU had moderate to severe Acute Respiratory Distress Syndrome (ARDS). Older age (61 years and above, mortality 17%), male sex (16.7% deaths among 90 critically ill male COVID patients) and presence of co-morbid conditions appear to have higher mortality in this study. However apart from co-morbid conditions (p=0.001) none was statistically significant. The overall mortality in this study of 120 critically ill COVID patients was 14.2%.
Conclusion: From this study, it can be suggested that survival of critically ill COVID patients can further be improved by better management of their co-morbid conditions and avoiding complications of invasive ventilation. However, further multicentric studies with large sample size are needed to confirm these findings.
Coronavirus disease-2019, High flow nasal canula, Mechanical ventilation, Remdesivir, Severe acute respiratory syndrome-coronavirus-2
Date of Submission: Feb 11, 2021
Date of Peer Review: Mar 10, 2021
Date of Acceptance: Mar 30, 2021
Date of Publishing: May 01, 2021
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA
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ETYMOLOGY: Author Origin
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