Mortality Rate and Predictors among Patients with COVID-19 Related Acute Respiratory Failure Requiring Mechanical Ventilation: A Retrospective Single Centre Study
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Jan 29, 2021
About this article
Article Category: Research Article
Published Online: Jan 29, 2021
Page range: 21 - 27
Received: Aug 05, 2020
Accepted: Nov 22, 2020
DOI: https://doi.org/10.2478/jccm-2020-0043
Keywords
© 2021 Christophe de Terwangne, Antonio Sorgente, Redente Tortora, Diana Cheung, Frederic Duprez, Sammy Place, Jerome R. Lechien, Lucio Capulzini, Michael De Cubber, Sven Saussez, Fabio Silvio Taccone, Shahram Mashayekhi, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Fig. 1
Baseline and clinical characteristics of COVID-19 patients, according to the overall outcome_
| All (n=49) | Survivors (n=22) | Non-Survivors (n=27) | p-value | |
|---|---|---|---|---|
| Age | 71 (61,5-77) | 66,50 (54,3-71,3) | 73 (65-80) | 0.007 |
| Age > 71 years | 22 (45%) | 5 (23%) | 17 (63%) | 0.009 |
| Female Gender | 15 (31%) | 7 (32%) | 8 (30%) | 1.00 |
| Time from symptoms to mechanical ventilation (days) | 7.5 (5-12) | 8.5 (6-11.75) | 7 (3.5-11.5) | 0.226 |
| Time from hospital admission to mechanical ventilation (days) | 2 (1-5) | 2.5 (0-4.75) | 2 (1-5) | 0.573 |
| Oral antidiabetic | 10 (20%) | 4 (18%) | 6 (22%) | 1.000 |
| Insulin | 6 (12%) | 3 (14%) | 3 (11%) | 1.000 |
| Antiplatelet therapy | 15 (31%) | 11 (41%) | 4 (18%) | 0.123 |
| Anticoagulation therapy | 6 (12%) | 4 (15%) | 2 (9%) | 0.678 |
| RAAS inhibitor | 16 (33%) | 5 (23%) | 11 (41%) | 0.229 |
| History or active smoking | 19 (39%) | 7 (32%) | 12 (44%) | |
| COPD | 3 (6%) | 2 (9%) | 1 (4%) | 1.000 |
| Sleep Apnoea | 10 (20%) | 5 (23%) | 5 (19%) | 0.726 |
| Asthma | 4 (8%) | 2 (9%) | 2 (7%) | 1.000 |
| Diabetes | 20 (41%) | 10 (45%) | 10 (37%) | 0.574 |
| Dyslipidemia | 25 (51%) | 12 (55%) | 13 (48%) | 0.573 |
| Cardiovascular-cerebrovascular disease | 15 (31%) | 10 (37%) | 5 (23%) | 0.358 |
| Chronic Ischemic heart disease | 7 (14%) | 2 (9%) | 5 (19%) | 0.436 |
| Hypertension | 32 (65%) | 13 (59%) | 19 (70%) | 0.548 |
| History of stroke | 5 (10%) | 2 (9%) | 3 (11%) | 1.000 |
| Peripheral Arterial disease | 7 (14%) | 2 (9%) | 5 (19%) | 0.436 |
| Hepatopathy or cirrhosis | 2 (4%) | 1 (5%) | 1 (4%) | |
| History of cured cancer | 6 (12%) | 3 (14%) | 3 (11%) | 1.000 |
| Actively treated cancer | 1 (2%) | 0 (0%) | 1 (4%) | 1.000 |
| Chronic kidney disease | 8 (16%) | 3 (14%) | 5 (19%) | 0.715 |
| Immunosuppression | 6 (12%) | 2 (9%) | 4 (15%) | 0.678 |
| Charlson score | 4 (2-6) | 2.5 (1-4.75) | 5 (3-6) | 0.026 |
| Charlson score > 2 | 34 (69%) | 11 (50%) | 23 (85%) | 0.012 |
| Fever | 37 (76%) | 18 (82%) | 19 (70%) | 0.507 |
| Cough | 34 (69%) | 17 (77%) | 17 (63%) | 0.358 |
| Dyspnoea | 35 (71%) | 14 (64%) | 21 (78%) | 0.348 |
| Chest pain | 5 (10%) | 2 (9%) | 3 (11%) | 1 |
| Dysgeusia/Anosmia | 5 (10%) | 3 (14%) | 2 (7%) | 0.646 |
| Myalgia | 18 (37%) | 9 (41%) | 9 (33%) | 0.767 |
| Headache | 11 (22%) | 7 (32%) | 4 (15%) | 0.185 |
| Nausea | 9 (18%) | 5 (23%) | 4 (15%) | 0.713 |
| Vomiting | 6 (12%) | 3 (14%) | 3 (11%) | 0.314 |
| Abdominal pain | 4 (8%) | 2 (9%) | 2 (7%) | 1 |
| Diarrhoea | 11 (22%) | 6 (27%) | 5 (19%) | 0.510 |
| Litres of O2 administered at admission in ICU | 10 (6-15) | 8 (4-15) | 11 (7-15) | 0.071 |
| pH | 7.45 (7.36-7.48) | 7.47 (7.39-7.51) | 7.42 (7.34-7.47) | 0.075 |
| PaCO2, mmmHg | 35 (31-40) | 35 (29.5-39.75) | 35 (31-41) | 0.817 |
| PaO2, mmHg | 60 (53-70) | 58.5 (51.7-68.5) | 61 (53-70) | 0.717 |
| SpO2, % | 93 (89.1-96.5) | 92.7 (86.5-96.125) | 93 (89.8-96.6) | 0.936 |
| Lactate, mmol/L | 1.3 (0.9-2) | 1.25 (0.8-1.55) | 1.3 (1-2.15) | 0.197 |
| CRP, mg/l | 98 (167-235) | 171,5 (98-294) | 141,51 (95-220) | 0.457 |
| Leucocytes /mm3 | 7560 (6020-9040) | 7681 (6165-8820) | 7100 (5880-9435) | 0.680 |
| Haemoglobin g/dl | 12.5 (11-13.5) | 12,5 (11.1-14.8) | 12,2 (11.1-13.35) | 0.832 |
| Platelets x1000/mm3 | 191 (151-279) | 226 (153-310) | 181 (140-246) | 0.236 |
| Neutrophils /mm3 | 4980 (6640-7967) | 6975 (5325-8372) | 6140 (4820-7550) | 0.374 |
| Lymphocytes /mm3 | 670 (507-897) | 725 (610-1037) | 630 (425-730) | 0.060 |
| Urea mg/dl | 48 (29-72) | 38,5 (25.7-66.75) | 51 (37-74) | 0.184 |
| Creatinine mg/dl | 1.05 (0.78-1.6) | 0,985 (0.78-1.55) | 1,12 (0.79-1.56) | 0.424 |
| Sodium mmol/l | 137 (135-140) | 137,5 (134-140) | 137 (135-139) | 0.785 |
| Potassium mmol/l | 3.8 (3.5-4.4) | 3,845 (3.4-4.1) | 3,835 (3.58-4.71) | 0.108 |
| Total Bilirubin mg/dL | 0.545 (0.43-0.70) | 0,48 (0.38-0.6) | 0,57 (0.39-0.79) | 0.268 |
| Gamma-glutamyl-transferases UI/l | 79 (44.5-152.5) | 120 (52-183) | 56 (36-111) | 0.079 |
| Alkaline phosphatases UI/l | 71 (51.5-123) | 84 (63.5-138.25) | 57 (42-91) | 0.072 |
| Aspartate aminotransferase (SGOT) UI/l | 52 (37.3-63.8) | 55,5 (35.5-89.25) | 48 (36.5-61) | 0.692 |
| Alanine aminotransferases (SGPT) UI/l | 32 (21.5-48) | 36 (20.75-63.5) | 31 (20-39.5) | 0.475 |
| Lactate dehydrogenases UI/l | 543 (438.5-669.5) | 537,5 (464-631) | 543 (411-694) | 0.765 |
| Creatinine phosphokinases UI/l | 135 (75-391) | 121 (64-287) | 112 (38-456) | 0.687 |
| Vasopressor | 35 (71%) | 13 (59%) | 22 (81%) | 0.100 |
| Intubation within 6 hours of admission | 36 (73%) | 19 (86%) | 17 (63%) | 0.180 |
| Tracheostomy | 11 (45%) | 11 (20%) | 0 (0%) | <0.001 |
| Prone Positioning | 28 (57%) | 14 (64%) | 14 (52%) | 0.344 |
| NMBAs | 39 (80%) | 20 (91%) | 19 (70%) | 0.665 |
| RRT | 14 (29%) | 6 (27%) | 8 (30%) | |
| Length of stay in ICU | 14 (8-28) | 28 (13-40) | 10 (6.5-14.5) | <0.001 |
| Duration of mechanical ventilation | 12 (6-18) | 16 (7.5-27) | 8 (4-14) | 0.006 |
| SOFA score at intubation | 4 (1-5) | 1 (0-4) | 4 (1-5) | 0.109 |
| Ventilation Acquired Pneumonia | 21 | 15 (68%) | 6 (22%) | 0,002 |
Multivariable logistic regression analysis to identify predictors of mortality_
| Univariate analysis | Multivariate analysis | |||||
|---|---|---|---|---|---|---|
| Variable | ||||||
| OR | 95% CI | p-value | OR | 95% CI | p-value | |
| Tracheostomy | 0.000 | (0.000) | <0.001 | 0.000 | 0.998 | |
| Age > 71 year-old | 5.780 | 1.629-20.513 | 0.009 | 4.597 | 0.706-29.914 | 0.110 |
| Charlson score > 2 | 5.750 | 1.489-22.208 | 0.012 | 3.588 | 0.621-20.746 | 0.154 |