J Res Med Sci . Association of systemic complications with mortality in coronavirus disease of 2019: A cohort study on intensive care unit patients

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J Res Med Sci


. 2022 Apr 15;27:34.
doi: 10.4103/jrms.JRMS_1213_20. eCollection 2022.
Association of systemic complications with mortality in coronavirus disease of 2019: A cohort study on intensive care unit patients


Mohammad Ali Ashraf ¹ , Alireza Sherafat ² , Zohre Naderi ³ , Ramin Sami ³ , Forogh Soltaninejad ⁴ , Saba Khodadadi ⁵ , Sanaz Mashayekhbakhsh ⁵ , Negar Sharafi ² , Somayeh Haji Ahmadi ⁶ , Azin Shayganfar ⁶ , Iman Zand ⁷ , Ali Ajami ⁸ , Kiana Shirani ⁹



Affiliations

• PMID: 35548176
• PMCID: PMC9081519
• DOI: 10.4103/jrms.JRMS_1213_20

Abstract

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.

Keywords: Coronavirus disease 2019; Iran; extrapulmonary manifestations; systemic complications.