Clinical characteristics and outcome of Covid-19 illness and predictors of in-hospital mortality in Saudi Arabia

Patient Characteristics and Clinical Outcomes During the 2020-2021 COVID-19 Wave: An Observational Study at a Tertiary Hospital in Saudi Arabia

Background and objective The continued prevalence and threat of coronavirus disease 2019 (COVID-19) have been reported, and evidence suggests that several people still get infected with the virus. Gaining a thorough understanding of the patient demographic factors and laboratory findings could contribute to assessing the severity, mortality, and progression of COVID-19. In light of this, the current study aimed to evaluate the demographic characteristics, laboratory findings, and outcomes of confirmed COVID-19 patients at a tertiary hospital in the Kingdom of Saudi Arabia (KSA). Methodology We collected data spanning the period 2020-2021 from the electronic health records of Al-Noor Specialized Hospital, Ma including demographics (age, gender, and nationality), severity (i.e., ICU admission), length of hospital stay, mortality, and laboratory parameters. Results We observed an overall mortality rate of 10.2% (338 of 3,307 patients). The mortality rate was significantly higher in males (n=210; 62.1%) and patients aged more than 70 years (n=91; 26.9%). Patients with blood group O comprised 131 (29%) of the 338 non-survivors, followed by those with A (n=85; 25.1%) and B groups (n=79; 23.4%). The mortality rate among ICU patients was 63.3% (n=214). Furthermore, the following laboratory findings showed abnormal mean values in terms of severity and mortality in COVID-19 patients: hemoglobin (HB) concentration, white blood cell (WBC) count, lymphocyte count (LC), C-reactive protein (CRP), creatinine (CREA), and uric acid (UA) levels. Conclusions Old age, male gender, and certain laboratory findings have a critical role in the severity and mortality risk in COVID-19 patients. There was no significant association between blood type and the severity and mortality of COVID-19. Continuous monitoring based on these findings may be essential to managing COVID-19 patients.

Clinical characteristics and outcomes of COVID-19 cases admitted to adult intensive care units during the pandemic: A single center experience

BACKGROUND

COVID-19 is the largest recorded pandemic in history. It causes several complications such as shock, pneumonia, acute respiratory distress syndrome, and organ failure. The objective was to determine COVID-19 outcomes and risk factors in the intensive care (ICU) setting.

METHODS

A retrospective review of prospectively collected data was conducted. Adult patients with a positive RT-PCR test for COVID-19 admitted to ICUs of a tertiary care hospital between 2020 and 2022 were included. Patients who had severe complex trauma were excluded. The outcomes examined included ventilation use and duration, length of stay (LOS), and mortality.

RESULTS

A total of 964 patients were included. The mean ( ± standard deviation, SD) age was 63.7 ± 16.9 years. The majority of the patients were males (59.0 %) and Saudi (75.7 %). Ventilation use was documented in 443 (57.1 %) patients, with a mean ( ± SD) ventilation duration of 9.7 ± 8.4 days. Death occurred in 361 (37.4 %) patients after a mean ( ± SD) of 33.3 ± 44.5 days from infection. The mean ( ± SD) LOS was 30.6 ± 54.1 days in hospital and 5.2 ± 5.4 days in ICU. Ventilation use was associated with older age, males, longer ICU LOS, mortality, and admission to medical-surgical ICU. Crude mortality use was associated with older age, longer ICU LOS, use of ventilator, shorter ventilation duration, and admission to medical-surgical or respiratory ICUs.

CONCLUSIONS

COVID-19 patients admitted to adult ICUs are at high risk of death and mechanical ventilation. The crude risks of both outcomes are higher in older age and longer ICU LOS and are very variable by ICU type.

Clinical characteristics and factors for serious outcomes among outpatients infected with the Omicron subvariant BF.7

To evaluate clinical characteristics and identify risk factors associated with severe outcomes in outpatients infected with the Omicron subvariant BF.7, data were collected from outpatients diagnosed with Corona Virus Disease 2019 from December 19, 2022 to January 5, 2023. Clinical characteristics were analyzed using descriptive statistics. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with serious outcomes. Variables with a p < 0.10 in the univariate analysis were included in the multivariate model. Our study analyzed 770 patients, of whom 380 (49.4%) were male, with a median age of 59. The most common symptoms reported were cough (71.2%), fever (64.7%), and sore throat (37.7%). Fever lasted an average of 5.93 ± 3.37 days for the general population and 10.64 ± 7.12 days for impaired-immunity patients. Most cases were mild (68.7%), followed by moderate (27.1%). Severe cases accounted for 2.2%, with 0.5% critically ill. Serious outcomes occurred in 4.2% of cases, with 11 deaths during follow-up. Underlying-diseases patients had a higher rate of serious outcomes. Factors associated with serious outcomes included receiving a three-dose vaccination (odds ratio [OR] = 0.324, 95% confidence interval [CI]: 0.113-0.932, p = 0.037), male gender (OR = 2.890, 95% CI: 1.107-7.548, p = 0.030), age (OR = 1.060, 95% CI: 1.024-1.097, p = 0.001), and chest tightness or dyspnea at the time of visit (OR = 4.861, 95% CI: 2.054-11.507, p < 0.001). Our study found that cough, fever, and sore throat were the most common symptoms reported by patients. Receiving a three-dose vaccination was protective, while male gender, age, and chest tightness or dyspnea were identified as risk factors for serious outcomes.

Predictive value of ferritin, glucose, urea, and creatinine for COVID-19 severity and mortality in patients from Asir, Saudi Arabia

OBJECTIVES

To correlate demographics, blood groupings, and laboratory characteristics of hospitalized COVID-19 patients with disease severity and outcomes.

METHODS

This study included 294 COVID-19 patients. Data on patient age, gender, laboratory results, clinical severity, mortality, comorbidities, and blood group were obtained from medical records retrospectively.

RESULTS

High levels of ferritin (p<0.01), urea (p<0.0001), and creatinine (p<0.05) were detected in intensive care unit (ICU)-admitted patients. Ferritin (p<0.05), glucose (p<0.0001), urea (p<0.0001), and creatinine (p<0.0001) were significantly higher in non-survivor compared to survivor COVID-19 patients. Predictors for ICU admission among patients were ferritin (odd ratio [OR]=0.999, p=0.0055) and urea (OR=0.991, p=0.0001). Predictors for mortality were: age (OR=0.963, p=0.0001), ferritin (OR=0.999, p=0.0149), glucose (OR=0.993, p=0.0001), urea (OR=0.976, p=0.0001), and creatinine (OR=0.556, p=0.0001). The most reliable laboratory parameters in predicting mortality were: age (area under the curve [AUC]=0.685, p<0.0001), ferritin (AUC=0.610, p<0.05), glucose (AUC=0.681, p<0.0001), urea (AUC=0.856, p<0.0001), and creatinine (AUC=0.823, p<0.0001).

CONCLUSION

High ferritin, glucose, urea, and creatinine levels may predict poor outcomes in COVID-19 patients. These findings could help predict admissions to the ICU and mortality among such patients.

Clinico-Epidemiological Laboratory Findings of COVID- 19 Positive Patients in a Hospital in Saudi Arabia

Background

Understanding COVID-19's onset and clinical effects requires knowing host immune responses.

Objective

To investigate the presence of IgM, IgG, and cytokine levels (IL-2 and IL-6) in individuals with COVID-19 who have had their diagnosis confirmed by PCR.

Methods

This cross-sectional research included 70 adult ICU patients from King Abdullah Hospital in Bisha, Saudi Arabia. Subjects gave two blood samples. After hospital release, only 21 patients provided the second sample. Each patient provided a sample upon admission. Quantitative ELISAs evaluated IL-2, IL-6, and SARS-CoV-2-specific IgM and IgG antibodies.

Results

All patients were critically ill and unvaccinated against COVID-19. 46 (65.7%) of the patients were male, and their age range was 33-98 years (with a mean age of 66.5); 24.3%) were 51-61 years old. IgG was positive in all patients, although IgM predominated in 57/70 (81.4%) (6-1200 IU/mL). Total data analysis yielded these results. IL-6 was calculated at 10-1900 ng/mL, whereas IL-2 was 4-280. Discharged hospital patients had a statistically significant increase in IgM and IgG (P = 0.01, 0.004) but a statistically insignificant decline in IL-6 and IL-2 (P = 0.761, 0.071). Low IgM levels increased hospital stays. The study found lengthier hospital stays with higher IgG levels.

Conclusion

The identification of IgM and IgG antibodies, greater IL-6 levels, and lower IL-2 levels can help diagnose and monitor COVID-19 infection.

Exploration of Sex and Age-Based Associations in Clinical Characteristics, Predictors of Severity, and Duration of Stay among COVID-19 Patients at the University Hospital of Saudi Arabia

COVID-19 infection has a spectrum of variable clinical severity between populations because of their characteristic demographic features, co-morbidities, and immune system reactions. This pandemic tested the healthcare system's preparedness, which depends on predictors of severity and factors related to the duration of hospital stays. Therefore, we carried out a single-center, retrospective cohort study in a tertiary academic hospital to investigate these clinical features and predictors of severe disease and study the different factors that affect hospital stay. We utilized medical records from March 2020 to July 2021, which included 443 confirmed (positive RT-PCR) cases. The data were explained using descriptive statistics and analyzed via multivariate models. Among the patients, 65.4% were female and 34.5% were male, with a mean age of 45.7 years (SD ± 17.2). We presented seven age groups with ranges of 10 years and noticed that patients aged 30-39 years old comprised 23.02% of the records, while patients aged 70 and above comprised 10%. Nearly 47% were diagnosed as having mild, 25% as moderate, 18% as asymptomatic, and 11% as having a severe case of COVID-19 disease. Diabetes was the most common co-morbidity factor in 27.6% of patients, followed by hypertension (26.4%). Our population's predictors of severity included pneumonia, identified on a chest X-ray, and co-morbid conditions such as cardiovascular disease, stroke, ICU stay, and mechanical ventilation. The median length of hospital stay was six days. It was significantly longer in patients with a severe disease and who were administered systemic intravenous steroids. An empirical assessment of various clinical parameters could assist in effectively measuring the disease progression and follow-up with patients.