Clinical Characteristics, Outcomes and Prognostic Factors for Critical Illness in Hospitalized COVID-19 Patients in Saudi Arabia: A Retrospective Cohort Study

Asmaa M El-Kady,1 Fahad M Aldakheel,2 Khaled S Allemailem,3 Ahmad Almatroudi,3 Reem Dbas Alharbi,3 Hamad Al Hamed,4 Muslimah Alsulami,5 Wafa A Alshehri,5 Saeed El-Ashram,6 Eugene Kreys,7 Khalil Mohamed,8 Wafa Abdullah I Al-Megrin,9 Hatem A Elshabrawy10 1Department of Medical Parasitology, Faculty of Medicine, South Valley University, Qena, 83523, Egypt; 2Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Saudi Arabia; 3Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, 51452, Saudi Arabia; 4Department of Laboratory and Blood Bank, King Fahd Specialist Hospital, Buraydah, 52211, Saudi Arabia; 5Department of Biology, College of Science, University of Jeddah, Jeddah, 21959, Saudi Arabia; 6Faculty of Science, Kafrelsheikh University, Kafr El-Sheikh, 33516, Egypt; 7Department of Clinical & Administrative Sciences, College of Pharmacy, California Northstate University, Elk Grove, CA, 95757, USA; 8Department of Epidemiology, Faculty of Public Health and Health Informatics, Umm Al-Qura University, Mecca, Saudi Arabia; 9Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Riyadh, 11671, Saudi Arabia; 10Department of Molecular and Cellular Biology, College of Osteopathic Medicine, Sam Houston State University, Conroe, TX, 77304, USACorrespondence: Asmaa M El-Kady; Hatem A Elshabrawy, Email Asmaa.elkady@med.svu.edu.eg; hatem.elshabrawy@shsu.eduBackground: A good understanding of the possible risk factors for coronavirus disease 19 (COVID‐19) severity could help clinicians in identifying patients who need prioritized treatment to prevent disease progression and adverse outcome. In the present study, we aimed to correlate clinical and laboratory characteristics of hospitalized COVID-19 patients to disease outcome in Saudi Arabia.Materials and Methods: The present study included 199 COVID-19 patients admitted to King Fahd Specialist Hospital, Buraydah, Qassim, Saudi Arabia, from April to December 2020. Patients were followed-up until discharge either for recovery or death. Demographic data, clinical data and laboratory results were retrieved from electronic patient records.Results: Critical COVID-19 cases showed higher mean of age and higher prevalence of co-morbid conditions. Fifty-five patients died during the observation period. Risk factors for in hospital death for COVID 19 patients were leukocytosis (OR 1.89, 95% CI 1.008– 3.548, p = 0.081), lymphocytopenia (OR 2.152, 95% CI 1.079– 4.295, p = 0.020), neutrophilia (OR 1.839, 95% CI 0.951– 3.55, p = 0.047), thrombocytopenia (OR 2.152, 95% CI 0.852– 5.430, p = 0.085), liver injury (OR 2.689, 95% CI 1.373– 4.944, p = 0.003), acute kidney injury (OR 1.248, 95% CI 0.631– 2.467 p = 0.319), pancreatic injury (OR 1.973, 95% CI 0.939– 4.144, p = 0.056) and high D dimer (OR 2.635, 95% CI 0.747– 9.287, p = 0.091).Conclusion: Clinical and laboratory data of COVID-19 patients may help understanding the pathogenesis of the disease and subsequently improve of the outcome of patients by determination of the associated risk factors and recognition of high risk group who are more liable for complications and in hospital death. The present study put an eye on some parameters (laboratory and clinical) that should be alarming signs that the patient is at high risk bad prognosis.Keywords: clinical, outcomes, prognosis, COVID-19, Saudi Arabia