Association of systemic complications with mortality in coronavirus disease of 2019: A cohort study on intensive care unit patients

Mohammad Ali Ashraf; Alireza Sherafat; Zohre Naderi; Ramin Sami; Forogh Soltaninejad; Saba Khodadadi; Sanaz Mashayekhbakhsh; Negar Sharafi; Somayeh Haji Ahmadi; Azin Shayganfar; Iman Zand; Ali Ajami; Kiana Shirani

doi:10.4103/jrms.JRMS_1213_20

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ORIGINAL ARTICLE

Year : 2022 | Volume : 27 | Issue : 1 | Page : 34

Association of systemic complications with mortality in coronavirus disease of 2019: A cohort study on intensive care unit patients

Mohammad Ali Ashraf¹, Alireza Sherafat², Zohre Naderi³, Ramin Sami³, Forogh Soltaninejad⁴, Saba Khodadadi⁵, Sanaz Mashayekhbakhsh⁵, Negar Sharafi², Somayeh Haji Ahmadi⁶, Azin Shayganfar⁶, Iman Zand⁷, Ali Ajami⁸, Kiana Shirani⁹
¹ Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
² Department of Undergraduate, School of Medicine, University of Central Lancashire, Preston, United Kingdom
³ Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
⁴ Department of Internal Medicine, Respiratory Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
⁵ Department of Undergraduate, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
⁶ Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
⁷ Department of Cardiology, Isfahan University of Medical Sciences, Isfahan, Iran
⁸ Department of Laboratory Health, Isfahan University of Medical Sciences, Isfahan, Iran
⁹ Assistant Professor of Infectious Diseases, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Correspondence Address:
Dr. Kiana Shirani
Khorshid Hospital, Ostandari Street, Isfahan
Iran

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/jrms.JRMS_1213_20

Background: Since the beginning of the coronavirus disease of 2019 (COVID-19) pandemic, concerns raised by the growing number of deaths worldwide. Acute respiratory distress syndrome (ARDS) and extrapulmonary complications can correlate with prognosis in COVID-19 patients. This study evaluated the association of systemic complications with mortality in severely affected COVID-19 patients. Materials and Methods: This retrospective study was done on 51 intensive care unit (ICU)-admitted COVID-19 adult patients who were admitted to the ICU ward of Khorshid hospital, affiliated with Isfahan University of Medical Sciences. Only the patients who had a definite hospitalization outcome (dead vs. survivors) were included in the study. Daily clinical and paraclinical records were used to diagnose in-hospital complications in these patients. Results: The sample was comprised of 37 males (72.5%) and 14 females (27.4%). The median age of patients was 63 years (Min: 20, Max: 84), with the mortality rate of 47.1%. In total, 70.6% of patients had at least one coexisting disorder. Chronic kidney disease was associated with the worse outcome (29.16% of dead patients against 3.70 of survived ones). Mechanical ventilation was used in 58.8% of patients. Patients who had received invasive ventilation were more likely to die (87.50% of dead patients against 7.40 of survivors), Complications including sepsis and secondary infections (odds ratio: 8.05, confidence interval: 2.11–30.63) was the strongest predictors of mortality. Conclusion: Complications including sepsis and secondary infections can increase the risk of death in ICU-admitted COVID-19 patients. Therefore, it is substantial that the physicians consider preventing or controlling these complications.

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