Primary Indicators of Critical Illness in Coronavirus Disease-2019
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- Category: Vol. 89, September 2021
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Primary Indicators of Critical Illness in Coronavirus Disease-2019 , HOUSSAM ELDIN H. ABD ELNABY, M.D.; MOSTAFA A.R. HUSSEIN, M.D.;MOHAMMAD A.A. AMIN, M.D. and MOHAMMAD E. ABO-GHABSHA, M.D.
Abstract
Background: Many studies discussed numerous predictors of severity in Coronavirus disease-2019 (COVID-19) patients.However, very limited number of these studies concerned with finding indicators of disease progression, ICU admission and life-threatening complications in such patients. Aim of Study: To determine some of the baseline indicators that lead COVID-19 patients to develop the critically ill form of the disease. Patients and Methods: This cross sectional study was conducted during the period from January 2021 to March 2021. It included 40 patients with COVID-19 infection, proved by positive reverse trascriptase real-time PCR (rt RT-PCR) dmitted to Al-Hussein and Bab Al-Sha'reia University Hospitals (quarantine sectors). Studied patients were divided into two equal groups, based on the classification of the Chinese Centers of Disease Control and Prevention (CDC): (1) Severe (non-critically ill) group and (2) Critically ill group. Demographic data and co-morbidities of all participants were recorded and BMI was calculated. Baseline CBC, AST, ALT, ESR, CRP, ferritin, D-dimer and HRCT chest were done for all patients. Results: Age, sex, BMI, smoking habit, CBC indices, ALT, AST and CRP did not show significant differences between severe and critically ill groups. However, ESR, Ddimer, ferritin, HRCT chest score, hypertension and diabetes mellitus showed statistically significant assosciation with the critically ill patients (p-value <0.05). HRCT chest score and hypertension were proved to be independent variables significantly associated with critical illness, unlike ESR which is a dependent variable. Hypertensive patients were 40 times more likely to be critically ill compared to non-hypertensive COVID-19 patients (adjusted OR=40.238). Additionally, for every increase in HRCT chest score by one point, the odds of being critically ill among COVID-19 patients increased twice (adjusted OR=2.1). Conclusion: Hypertension and diabetes mellitus increase the risk of developing critical illness in COVID-19 patients. Elevated ESR, D-dimer, ferritin levels and the more the percentage of HRCT chest involvement are associated with critical illness as well.
Primary Indicators of Critical Illness in Coronavirus Disease-2019