The clinical course and frequency of risk factors associated with mortality in severe COVID-19 ARDS in ICU

Abstract

Importance: in light of the high frequency of patients with severe ARDS in the observed popu­lation, this article was written to describe the frequency of the risk factors that impact on mortality and thus increase the quality of care for these patients.

Objective: to describe the frequency of risk factors associated with mortality in patients with severe COVID-19 ARDS hospitalized in the ICU of Clínica Belén de Fusagasugá from July 2020 to January 2021.

Design: an observational, descriptive, retrospective study including 115 patients admitted to the ICU at Clínica Belén de Fusagasugá with severe COVID-19 ARDS from July 2020 to January 2021.

Results: among the 115 patients who met the inclusion criteria there was a COVID-19 fatal­ity rate of 49%. The use of IMV was related to mortality (p=0.000). The comorbidities related to mortality were hypertension (p=0.005), heart disease (p=0.024) and COPD (p=0.004). The median age of the population was 74 years. There was a high correlation between age and mortality; all the mortality risk scales were significant, except COVID-GRAM. Complications were more frequent in those who died, but only acute kidney injury (p=0.000), gastrointestinal bleeding (p=0.024) and fungemia (p=0.027) showed statistical significance.

Conclusions: the fatality rate for severe COVID-19 ARDS was 15%; the risk factors most fre­quently associated with mortality were: age, need for IMV, HTN, diabetes and COPD. A correlation was found between the severity scales used (like NEWS2, APACHE II, SOFA, and MuLBSTA) and mortality.