Risk Factors of 90-Day Mortality in Patients with Critical Covid-19 Infection
1Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Izmir, Turkey
2Dokuz Eylül University Faculty of Medicine, Department of Anesthesiology and Reanimation and Critical Care, Izmir, Turkey
3Izmir Medicana International Hospital, Division of Intensive Care Medicine, Department of Internal Medicine, Izmir, Turkey
4Dokuz Eylül University Faculty of Medicine, Department of Pulmonary and Critical Care, Izmir, Turkey
J Crit Intensive Care 2022; 13(2): 57-65 DOI: 10.37678/dcybd.2022.2977
Full Text PDF

Abstract

Aim: Mortality risk factors and effective treatment approaches are still uncertain for the SARS-CoV-2. In this study, we aimed to determine risk factors of 90-day mortality critically ill patients with COVID-19 infection.
Materials and Methods: All patients hospitalized in the intensive care unit of the university hospital with the diagnosis of COVID-19 pneumonia between 15 March and 30 November 2020 were reviewed in this retrospective study. The primary endpoint was 90-day mortality, while the secondary endpoints were in-hospital mortality, therapy responses for tocilizumab and corticosteroid treatments, duration of mechanical ventilation (MV), and length of hospital stay.
Results: A total of 145 patients, 105 (73%) men and 40 (27%) women were included in the study. Median age was 71.0 (58–79.50) years. In-hospital mortality was 62.8%, 28-day mortality was 60%, and 90-day mortality was 66.9% for the whole study population. In-hospital mortality was 58.4% (n=52) and 90-day mortality was 64.0% (n=57) in patients receiving corticosteroid treatment. Both in-hospital and 90-day mortality was found as 60% (n=12) in patients receiving tocilizumab. Age and duration of invasive mechanical ventilation were determined as independent risk factors on logistic regression analysis performed for 90-day mortality (OR 1.060 (1.018–1.103), p=0.005 and OR 1.057 (1.004–1.113, p=0.035), respectively).
Conclusions: Early and late mortality is high in patients with severe COVID 19 infection. Our results showed advanced age and duration of mechanical ventilation are independent risk factors for 90-day mortality. However long-term effect of corticosteroid and tocilizumab treatments on survival could not be demonstrated in this study.