Clinical Features and Outcomes of ICU Patients with COVID-19 Infection in Tehran, Iran: a Single-Centered Retrospective Cohort Study

Vahedi, Arshia; Tabasi, Farhad; Monjazebi, Fateme; Hashemian, Seyed Mohammad Reza; Tabarsi, Payam; Farzanegan, Behrooz; Malekmohammad, Majid; Salimi, Alireza; Salimi, Morteza; Raoufy, Mohammad Reza; Jamaati, Hamidreza; Velayati, Ali Akbar

Clinical Features and Outcomes of ICU Patients with COVID-19 Infection in Tehran, Iran: a Single-Centered Retrospective Cohort Study

Document Type : Original Article

Authors

Arshia Vahedi ¹

Farhad Tabasi ²

Fateme Monjazebi ³

Seyed Mohammad Reza Hashemian ¹

Payam Tabarsi ⁴

Behrooz Farzanegan ⁵

Majid Malekmohammad ⁵

Alireza Salimi ¹^{, 6}

Morteza Salimi ¹^{, 2}

Mohammad Reza Raoufy ²

Hamidreza Jamaati ¹

Ali Akbar Velayati ⁴

¹ Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

² Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

³ Department of Medical-Surgical Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

⁴ Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran

⁵ Tracheal Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran

⁶ Department of Anesthesiology and Critical Care, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: The clinical characteristics of the novel coronavirus disease (COVID-19) were diverse and unspecific. Here, we identified the associated factors with surviving of COVID-19 ICU patients based on the clinical characteristics of patients admitted to one of the Corona Centre Hospitals of Iran.
Materials and Methods: This cohort study was performed retrospectively from February to June 2020 on 133 COVID-19 patients admitted to 4 intensive care units of Masih Daneshvari Hospital in Tehran, Iran. Demographic, medical, clinical manifestation at admission, laboratory parameters and outcome data were obtained from medical records. Also the SOFA and APACHE II scores were calculated. All data were analyzed using SPSS (version 23, IBM Corp.) software.
Results: The median (IQR) age of the patients was 62.0 (54.0-72.0) years in total. RT-PCR of throat swab SARS-CoV-2 in 80 patients (60.2%) was positive. Total mortality rate was 57.9 percent (77 patients). Dyspnea, hypertension and chronic pulmonary diseases were significantly common in non-survivors than survivors (p <0.05). Both SOFA and APACHE II scores were significantly higher in the non-survivors (p <0.05). Also other significant differences were observed in other parameters of the study.
Conclusion: The mortality rate of COVID-19 patients admitted to ICU is generally high. Dyspnea as initial presentation and comorbidity, especially hypertension and pulmonary diseases, may be associated with higher risk of severe disease and consequent mortality rate. Also, higher SOFA and APACHE II scores could indicate higher mortality in patients admitted to ICU.

Keywords

Intensive Care Unit

COVID-19

Clinical features

Mortality