Factors related to survival in Intensive Care Unit patients with Covid-19: a study from a single center in Brazil

Resumo

Introduction: Analysis of the outcome of 268 ICU patients in a single-center, as well the impact of viral infection on patients with preexisting medical conditions and how these factors affected survival and hospital stay.

Methodology: Patients admitted to the ICU from March-August, 2020 were retrospectively analyzed under the same protocol at Hospital Alemão Oswaldo Cruz, São Paulo, Brazil. Several factors were considered and the results were presented using 95% confidence intervals. For statistical significance, p <0.05 was adopted.

Results: Patient median age was 72 years, 64,2 years for discharged patients and 79.9 years for those deceased (p<0.001). The most common comorbidities were: systemic arterial hypertension, diabetes, thyroid disease, cardiovascular and kidney disease. Predictors of survival through univariate analysis: myalgia (p=0.001), cerebrovascular disease (p=0.002), COPD (p=0.003), dementia (p=0.000), mechanical ventilation (p=0.000), dialysis (0.000), vasopressor use (0.000), SAPS3 (0.000), lymphopenia (p=0.004), elevated D-dimer (P=0.011), time in ICU before tracheostomy (p=0.002), and performing a tracheostomy (p=0.000). The independent predictors of mortality were: advanced age (p=0.003) and tracheostomy performed in ICU (p=0.002).

Discussion: COVID-19 affects usually older adults, where there already is a higher fatality rate. Acute respiratory distress syndrome is the primary cause of death and <5% of patients were reported as experiencing co-infection at admission.

Conclusion: age, vasopressor use in patients with tracheostomy, and systemic coronary disease, heart failure, neoplasia, and COPD, were found to be significantly associated with COVID-19 severity.