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      Predictors of mortality and ICU requirement in hospitalized COVID‐19 patients with diabetes: A multicentre study

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          Abstract

          Aim

          This study aimed to identify the predictors of mortality and ICU requirements in hospitalized COVID‐19 Patients with Diabetes.

          Design

          Cross‐sectional study.

          Methods

          It was a retrospective study of patients hospitalized with COVID‐19 infection from October 2020–February 2021 in four hospitals in Sylhet, Bangladesh. Logistic regression analysis was applied to explore the predictors of ICU requirement and in‐hospital mortality.

          Results

          In the whole cohort ( n = 500), 11% of patients died and 24% of patients required intensive care unit (ICU) support. Non‐survivors had significantly higher prevalence of lymphopenia, thrombocytopenia and leukocytosis. Significant predictors of in‐hospital mortality were older age, neutrophil count, platelet count and admission peripheral capillary oxygen saturation (SpO2). Older age, ischemic heart disease, WBC count, D‐dimer and admission SpO2 were identified as significant predictors for ICU requirement.

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          No.

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          Most cited references58

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          Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

          Fei Zhou, Ting Yu, Ronghui Du … (2020)
          Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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            Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study

            Xiaobo Yang, Yuan Yu, Jiqian Xu … (2020)
            Summary Background An ongoing outbreak of pneumonia associated with the severe acute respiratory coronavirus 2 (SARS-CoV-2) started in December, 2019, in Wuhan, China. Information about critically ill patients with SARS-CoV-2 infection is scarce. We aimed to describe the clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia. Methods In this single-centered, retrospective, observational study, we enrolled 52 critically ill adult patients with SARS-CoV-2 pneumonia who were admitted to the intensive care unit (ICU) of Wuhan Jin Yin-tan hospital (Wuhan, China) between late December, 2019, and Jan 26, 2020. Demographic data, symptoms, laboratory values, comorbidities, treatments, and clinical outcomes were all collected. Data were compared between survivors and non-survivors. The primary outcome was 28-day mortality, as of Feb 9, 2020. Secondary outcomes included incidence of SARS-CoV-2-related acute respiratory distress syndrome (ARDS) and the proportion of patients requiring mechanical ventilation. Findings Of 710 patients with SARS-CoV-2 pneumonia, 52 critically ill adult patients were included. The mean age of the 52 patients was 59·7 (SD 13·3) years, 35 (67%) were men, 21 (40%) had chronic illness, 51 (98%) had fever. 32 (61·5%) patients had died at 28 days, and the median duration from admission to the intensive care unit (ICU) to death was 7 (IQR 3–11) days for non-survivors. Compared with survivors, non-survivors were older (64·6 years [11·2] vs 51·9 years [12·9]), more likely to develop ARDS (26 [81%] patients vs 9 [45%] patients), and more likely to receive mechanical ventilation (30 [94%] patients vs 7 [35%] patients), either invasively or non-invasively. Most patients had organ function damage, including 35 (67%) with ARDS, 15 (29%) with acute kidney injury, 12 (23%) with cardiac injury, 15 (29%) with liver dysfunction, and one (2%) with pneumothorax. 37 (71%) patients required mechanical ventilation. Hospital-acquired infection occurred in seven (13·5%) patients. Interpretation The mortality of critically ill patients with SARS-CoV-2 pneumonia is considerable. The survival time of the non-survivors is likely to be within 1–2 weeks after ICU admission. Older patients (>65 years) with comorbidities and ARDS are at increased risk of death. The severity of SARS-CoV-2 pneumonia poses great strain on critical care resources in hospitals, especially if they are not adequately staffed or resourced. Funding None.
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              Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

              Safiya Richardson, Jamie Hirsch, Mangala Narasimhan … (2020)
              There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).
              Article 0 comments Cited 4665 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Md Asaduzzaman:
                ORCID: https://orcid.org/0000-0001-9558-0594
                asad_somc@yahoo.com
                Journal
                Journal ID (nlm-ta): Nurs Open
                Journal ID (iso-abbrev): Nurs Open
                Journal ID (doi): 10.1002/(ISSN)2054-1058
                Journal ID (publisher-id): NOP2
                Title: Nursing Open
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2054-1058
                Publication date (Electronic): 27 December 2022
                Publication date PMC-release: 27 December 2022
                Electronic Location Identifier: 10.1002/nop2.1567
                Affiliations
                [ 1 ] Department of Medicine Sylhet MAG Osmani Medical College Hospital Sylhet Bangladesh
                [ 2 ] Department of Statistics Shahjalal University of Science and Technology Sylhet Bangladesh
                [ 3 ] Department of Medicine Sylhet MAG Osmani Medical College Sylhet Bangladesh
                Author notes
                [*] [* ] Correspondence

                Md Asaduzzaman, Sylhet MAG Osmani Medical College Hospital, Sylhet‐3100, Bangladesh.

                Email: asad_somc@ 123456yahoo.com

                Author information
                https://orcid.org/0000-0001-9558-0594
                https://orcid.org/0000-0002-2899-804X
                Article
                Publisher ID: NOP21567 Other ID: NOP-2022-Jul-1090.R2
                DOI: 10.1002/nop2.1567
                PMC ID: 9880734
                PubMed ID: 36575597
                SO-VID: 8cd07093-9ad7-4b18-bd3d-5a5cc9f927dc
                Copyright © © 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Date revision received : 15 November 2022
                Date received : 04 August 2022
                Date accepted : 10 December 2022
                Page count
                Figures: 2, Tables: 8, Pages: 13, Words: 7909
                Categories
                Subject: Empirical Research Quantitative
                Subject: Empirical Research Quantitative
                Custom metadata
                source-schema-version-number 2.0
                edited-state corrected-proof
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.4 mode:remove_FC converted:27.01.2023

                Keywords: covid‐19,dm,mortality,icu requirement
                Data availability:
                Keywords: covid‐19, dm, mortality, icu requirement

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