Predictors of Intensive Care Unit Admission among Hospitalized COVID-۱۹ Patients in a Large University Hospital in Tehran, Iran

  • سال انتشار: 1400
  • محل انتشار: مجله تحقیقات در علوم سلامت، دوره: 21، شماره: 1
  • کد COI اختصاصی: JR_JRHSU-21-1_006
  • زبان مقاله: انگلیسی
  • تعداد مشاهده: 129
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نویسندگان

Hossein Hatami

MD, MPH, Department of Public Health, School of Public Health and Safety and Environmental and Occupational Hazards Control Research Center, Shahid Beheshti Universityof Medical Sciences, Tehran, Iran

Hussein Solimantabar

MD, Department of Radiology, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Mehrdad Ghasemian

PhD, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Negar Delbari

MD, MPH, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Shayan Aryannezhad

MD, MPH, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran

چکیده

Background: The rapid increase in the spread of COVID-۱۹ and the numbers of infected patientsworldwide has highlighted the need for intensive care unit (ICU) beds and more advanced therapy. Thisneed is more urgent in resource-constrained settings. The present study aimed to identify the predictorsof ICU admission among hospitalized COVID-۱۹ patients.Study design: The current study was conducted based on a retrospective cohort design.Methods: The participants included ۶۶۵ definite cases of severe acute respiratory syndrome coronavirus۲ (SARS-CoV-۲) hospitalized in Imam Hossein Hospital from February ۲۰ to May ۱۴, ۲۰۲۰. The baselinecharacteristics of patients were assessed, and multivariate logistic regression analysis was utilized todetermine the significant odds ratio (OR) for ICU admission.Results: Participants were aged ۵۹.۵۲±۱۶.۷۲ years, and the majority (۵۵.۶%) of them were male.Compared to non-ICU patients (n=۵۴۷), the ICU patients (n=۱۱۸) were older, had more baselinecomorbidities, and presented more often with dyspnea, convulsion, loss of consciousness, tachycardia,tachypnea, and hypoxia, and less often with myalgia. Significant OR (۹۵% CI) of ICU admission wasobserved for the ۶۰-۸۰ age group (۲.۴۲, ۹۵%CI: ۱.۰۱; ۵.۷۹), ≥۸۰ age group (۳.۷۳, ۹۵%CI: ۱.۴۴; ۹.۴۲),≥۳ comorbidities (۲.۰۷, ۹۵%CI: ۱.۳۱; ۳.۸۰), loss of consciousness (۶.۷۰, ۹۵%CI: ۲.۹۴, ۱۵.۲۴), tachypnea(۱.۷۹, ۹۵%CI: ۱.۰۳, ۳.۱۱), and SpO۲< ۹۰ (۵.۸۳, ۹۵%CI: ۲.۷۴; ۱۲.۴). Abnormal laboratory results weremore common among ICU-admitted patients; in this regard, leukocytosis (۴.۴۵, ۹۵%CI: ۱.۴۹, ۱۳.۳۱),lymphopenia (۲.۳۹, ۹۵%CI: ۱.۳۰; ۴.۳۹), elevated creatine phosphokinase (CPK) (۱.۹۹, ۹۵%CI: ۱.۰۴;۳.۸۳), and increased aspartate aminotransferase (AST) (۲.۲۵, ۹۵%CI: ۱.۱۸-۴.۳۰) had a significant ORof ICU admission. Chest computer tomography (CT) revealed that consolidation (۱.۸۲, ۹۵%CI: ۱.۰۲,۳.۲۴), pleural effusion (۳.۱۹, ۹۵%CI: ۱.۷۱, ۵.۹۵), and crazy paving pattern (۸.۳۶, ۹۵%CI: ۱.۹۲, ۳۶.۴۸)had a significant OR of ICU admission.Conclusion: As evidenced by the obtained results, the predictors of ICU admission were identifiedamong epidemiological characteristics, presenting symptoms and signs, laboratory tests, and chest CTfindings.

کلیدواژه ها

SARS-CoV-۲, COVID-۱۹, Intensive Care Units, Risk factors, Critical care

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