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. 2022 Sep;47(5):450-460.
doi: 10.30476/IJMS.2021.89916.2068.

Predictors of Intensive Care Unit Admission in Patients with Confirmed Coronavirus Disease 2019: A Cross-Sectional Study

Naeimehossadat Asmarian  1 , Farid Zand  1 , Parvin Delavari  2 , Vahid Khaloo  3 , Zahra Esmaeilinezhad  1 , Golnar Sabetian  4 , Yaldasadat Moeini  1 , Mohsen Savaie  5 , Fatemeh Javaherforooshzadeh  5 , Farhad Soltani  5 , Farid Yousefi  6 , Ebrahim Heidari Sardabi  7 , Maryam Haddadzadeh Shoushtari  8 , Anoush Dehnadi Moghadam  9 , Fatemeh Dehnadi Moghadam  10 , Somayeh Gholami  11
Affiliations

Predictors of Intensive Care Unit Admission in Patients with Confirmed Coronavirus Disease 2019: A Cross-Sectional Study

Naeimehossadat Asmarian et al. Iran J Med Sci. 2022 Sep.

Abstract

Background: The coronavirus disease 2019 (COVID-19) has become the leading source of pneumonia outbreaks in the world. The present study aimed to compare the condition of intensive care unit (ICU) and non-ICU COVID-19 patients in terms of epidemiological and clinical features, laboratory findings, and outcomes in three cities across Iran.

Methods: In a cross-sectional study, 195 COVID-19 patients admitted to five hospitals across Iran during March-April 2020 were recruited. Collected information included demographic data, laboratory findings, symptoms, medical history, and outcomes. Data were analyzed using SPSS software with t test or Mann-Whitney U test (continuous data) and Chi square test or Fisher's exact test (categorical variables). P<0.05 was considered statistically significant.

Results: Of the 195 patients, 57.4% were men, and 67.7% had at least one comorbidity. The prevalence of stroke, chronic obstructive pulmonary disease, and autoimmune diseases was higher in ICU than in non-ICU patients (P=0.042, P=0.020, and P=0.002, respectively). Compared with non-ICU, ICU patients had significantly higher white blood cell (WBC) count (P=0.008), cardiac troponin concentrations (P=0.040), lactate dehydrogenase levels (P=0.027), erythrocyte sedimentation rates (P=0.008), and blood urea nitrogen (BUN) (P=0.029), but lower hematocrit levels (P=0.001). The mortality rate in ICU and non-ICU patients was 48.1% and 6.1%, respectively. The risk factors for mortality included age>40 years, body mass index<18 Kg/m2, hypertension, coronary artery disease, fever, cough, dyspnea, ST-segment changes, pericardial effusion, and a surge in WBC and C-reactive protein, aspartate aminotransferase, and BUN.

Conclusion: A high index of suspicion for ICU admission should be maintained in patients with positive clinical and laboratory predictive factors.

Keywords: COVID-19; Dyspnea; Intensive care unit; Pneumonia; SARS-CoV-2.

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Conflict of interest statement

Farid Zand, Editor-in-Chief, was not involved in the peer-review and decision-making processes for this manuscript. The non-author, Chairperson, oversaw the peer review process for this paper. Naeimehossadat Asmarian, as the Editorial Board Member, was not involved in any stage of handling this manuscript. A team of independent experts were formed by the Editorial Board to review the editor’s article without her knowledge.

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