1. Analysis of predictors and outcomes of COVID-19 patients requiring ICU admission from COVID 19
- Author
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Kamal Kajal, Karan Singla, Goverdhan Dutt Puri, Ashish Bhalla, Aparna Mukherjee, Gunjan Kumar, Alka Turuk, Madhumita Premkumar, Varun Mahajan, Thrilok Chander Bingi, Pankaj Bhardwaj, Mary John, Geetha R Menon, Damodar Sahu, Samiran Panda, Vishnu Vardhan Rao, Rajarao Mesipogu, Mohammed Ayaz Mohiuddin, Vinaya Sekhar Aedula, Manoj K Gupta, Akhil D Goel, Vikas Loomba, Maria Thomas, U K Ojha, R R Jha, Veeresh Salgar, Santosh Algur, Ashish Pathak, Ashish Sharma, Manju Purohit, Himanshu Dandu, Amit Gupta, Vivek Kumar, Lisa Sarangi, Mahesh Rath, Tridip Dutta Baruah, Pankaj Kumar Kannauje, Ajit Kumar, Rajnish Joshi, Saurabh Saigal, Abhishek Goel, Janakkumar R Khambholja, Amit Patel, Surabhi Madan, Nitesh Shah, V K Katyal, Deepinder Singh, Sandeep Goyal, Arti Shah, Amit Chauhan, Bhavesh Patel, Kala Yadhav M L, Dayananda V P, Chetana G S, Anita Desai, Manisha Panchal, Mayank Anderpa, Payal Tadavi, Sourin Bhuniya, Manoj Kumar Panigrahi, Shakti Kumar Bal, Sachin K Shivnitwar, Prajakta Lokhande, Srikanth Tripathy, Vijay Nongpiur, Star Pala, Md Jamil, Bal Kishan Gupta, Jigyasa Gupta, Rashmi Upadhyay, Saurabh Srivast, Simmi Dube, Preksha Dwivedi, Rita Saxena, Mohammed Shameem, Nazish Fatima, Shariq Ahmed, Nehal M. Shah, Soumitra Ghosh, Yogiraj Ray, Avijit Hazra, Arunansu Talukdar, Naveen Dulhani, Nyanthung Kikon, Subhasis Mukherjee, Susenjit Mallick, Lipilekha Patnaik, Sudhir Bhandari, Abhishek Agrawal, Rajaat Vohra, Nikita Sharma, Rajiv Kumar Bandaru, Mehdi Ali Mirza, Jaya Chakravarty, Sushila Kataria, Ratnamala Choudhury, Soumyadip Chatterji, and M.Pavan Kumar
- Abstract
BackgroundSevere Corona virus disease (COVID-19) is associated with high mortality. Although single centre intensive care units (ICU) have reported clinical characteristics and outcomes, no large scale multicentric study from India has been published. The present retrospective, multi-centre study was aimed to describe the predictors and outcomes of COVID-19 patients requiring ICU admission from COVID-19 Registry of Indian council of Medical Research (ICMR), India.MethodsProspectively collected data from multiple participating institutions was entered in the electronic National Clinical Registry of COVID 19. We enrolled patients aged>18 years with COVID-19 pneumonia requiring ICU admission between March 2020 and August 2021. Exclusion criteria were negative RT PCR, death within 24 hours of ICU admission, or patients with incomplete data in the registry Their demographic characteristics, laboratory variables, ICU severity indices, treatment strategies and outcomes were analysed.ResultsA total of 5865 patients, with mean age 56±15 years, with 3840/5865 (65.4%) men, were enrolled in the ICMR registry.. Overall mortality was 2535/5865 (43.5%). Non-survivors were older than survivors (58.2±15.4 years vs 53.6 ±14.7 years; P=0.001). Non-survivors had multiple comorbidities (n=1951, 52.9%) with hypertension (47.2%) and diabetes (45.6%) being the most common, higher creatinine (1.6 ± P=0.001, high D-dimer (1.56 vs 1.37, P=0.001), higher CT severity index (16.8±5.2 vs 13.5 ±5.47 ) compared to survivors. Non survivors had longer hospital and ICU stay (P=0.001). On multivariate regression analysis, high NLR (HR 1.017, 95% CI 1.005- 1.029, P=0.001), high CRP (HR 1.008, 95% CI 1.006- 1.010, P=0.001), high D dimer ((HR 1.089, 95% CI 1.065- 1.113, P=0.001) were associated with mechanical ventilation while younger age, (HR 0.974, CI 0.965-0.983, p=0.001), high D dimer (HR-1.014, CI 1.001-1.027, P=0.035) and use of prophylactic LMWH (HR 0.647, CI 0.527-0.794, p=0.001) were independently associated with mortality. ConclusionIn this large retrospective study of 5865 critically ill COVID 19 patients admitted to ICU, overall mortality was 2535/5865 (43.5%). Age, high D dimer, CT Severity score and use of prophylactic LMWH were independently associated with mortality.
- Published
- 2022