Clinical profile of mechanically ventilated COVID-19 patients: A retrospective observational study from Dubai

Abstract

Background: We did a retrospective analysis of critical coronavirus disease 2019 (COVID-19) patients admitted to our intensive care unit (ICU). The objective was to evaluate the outcome, risk factors and effect of prone position in critically ill patients requiring invasive mechanical ventilation (IMV).

Patients and methods: The data were collected regarding demographics, comorbidities, laboratory parameters and treatment. Logistic regression was used for analysis of the association of risk factors to the outcome.

Results: From 15 March to 30 May 2020, 35 (59.3%) out of 59 critical COVID-19 requiring IMV were admitted to a tertiary care hospital in Dubai. The day-28 ICU mortality was 28.8% and 48.6% in patients requiring IMV. Prone position (PP) was used in 17 (48.6%) patients for median duration of 19 (5-20) hours with significant PaO2/FiO2 improvement. Acute kidney injury was common (30.5%), and half of the patients required renal replacement therapy (RRT) with higher mortality (77.8%). Lactate dehydrogenase (LDH) odd ratio (OR)- 1.006 [95% CI- 1.00-1.01], D-dimer (OR-1.003 [1.000-1.000, low total leucocyte count (OR-1.135 [1.01-1.28]), and lymphopenia (OR-0.909 [0.84-0.98]) were independently associated with increased risk of IMV.

Conclusions: IMV requirement in patients with COVID-19 is associated with higher mortality. Inflammatory markers like LDH, D-dimer, and lymphopenia can be used to predict the prognosis. The patients with COVID-19 on IMV respond significantly with prone position, and it should be considered early with a longer duration.