Table 1.
Univariate Analysis of Factors Associated with Unfavorable Outcome in COVID-19 Patients Hospitalized in the ICU (Timișoara, Romania, October 2020–May 2021)
| Variable | Group 1 – Patients with Unfavorable Outcome (N1=179) | Group 2 – Patients with Favorable Outcome (N2=57) | p | OR [95% CI] |
|---|---|---|---|---|
| Age, years (median [IQR]) | 68.00 [60.00–72.00] | 60.00 [52.00–69.00] | 0.001 | 1.05 [1.02–1.07] |
| Male gender [n (%)] | 112(62.57) | 27(47.37) | 0.042 | 1.86 [1.02–3.39] |
| Days of hospitalization (median, [IQR]) | 9.00 [5.00–13.00] | 9.00 [7.00–12.00] | 0.927 | 1.00 [0.94–1.07] |
| Days with CVC [median, IQR] | 8.00[4.00–11.00] | 3.00[0.00–8.00] | <0.001 | 1.14 [1.07–1.22] |
| Days with peripheral venous catheter [median, IQR] | 0.00[0.00–2.00] | 4.00[0.00–8.00] | <0.001 | 0.787 [0.72–0.86] |
| Days with urinary catheter [median, IQR] | 9.00[5.00–13.00] | 8.00[7.00–12.00] | 0.553 | 1.02 [0.96–1.08] |
| Number of comorbidities [median, IQR] | 4.00[2.00–6.00] | 3.00[2.00–5.00] | 0.161 | 1.08[0.97–1.21] |
| Days of mechanical ventilation [median, IQR] | 5.00[3.00–9.00] | 0.00[0.00–2.00] | <0.001 | 1.31[1.18–1.46] |
| Days of non-invasive ventilation [median, IQR] | 2.00[0.00–6.00] | 3.00[0.00–6.00] | 0.478 | 0.97[0.90–1.05] |
| Days of O2 therapy – face mask [median, IQR] | 0.00[0.00–0.00] | 4.00[1.00–5.00] | <0.001 | 0.37[0.28–0.49] |
| O2 saturation [median, IQR] | 0.85[0.78–0.92] | 0.90[0.80–0.96] | 0.034 | 0.97[0.94–0.99] |
| Apache II score* [median, IQR] | 13.00[9.00–18.00] | 9.00[5.00–14.00] | 0.003 | 1.08[1.03–1.14] |
| Carmeli score** [median, IQR] | 2.00[2.00–2.00] | 2.00[2.00–2.00] | 0.016 | 3.14[1.24–7.99] |
| Charlson comorbidity index*** [median, IQR] | 4.00[2.00–5.00] | 2.00[1.00–4.00] | 0.001 | 1.29[1.11–1.51] |
| Critical COVID-19 upon ICU admission [n, %] | 67(37.43) | 12(21.05) | 0.022 | 2.24[1.11–4.54] |
| Severe COVID-19 upon ICU admission [n, %] | 111(62.01) | 41(71.93) | 0.173 | 0.64[0.33–1.22] |
| Hiperimmune plasma administration [n, %] | 5(2.79) | 1(1.75) | 1.00 | 1.61[0.18–14.06] |
| Prior antiviral treatment [n, %] | 138(77.09) | 44(77.19) | 0.987 | 0.99[0.49–2.02] |
| Prior corticosteroid treatment [n, %] | 138(77.09) | 44(77.19) | 0.987 | 0.99[0.49–2.02] |
| Tocilizumab [n, %] | 7(3.91) | 0(0) | 0.200 | ND |
| ARDS [n, %] | 169(94.41) | 37(64.91) | <0.001 | 9.14[3.95–21.13] |
| Superinfection [n, %] | 88(49.16) | 31(54.38) | 0.492 | 0.81[0.45–1.47] |
| COVID-19 end-organ damages | ||||
| Cardiac [n, %] | 29(16.20) | 4(7.02) | 0.122 | 2.56[0.86–7.63] |
| Hepatic [n, %] | 50(27.93) | 11(19.30) | 0.194 | 1.62[0.77–3.38] |
| Neurological [n, %] | 45(25.14) | 10(17.54) | 0.237 | 1.58[0.74–3.38] |
| Pancreatic [n, %] | 43(24.02) | 7(12.28) | 0.058 | 2.26[0.95–5.35] |
| Renal [n, %] | 46(25.70) | 5(8.77) | 0.006 | 3.59[1.35–9.55] |
| ALT (U/L) [median, IQR] | 39.00[27.00–68.00] | 39.00[25.00–61.00] | 0.623 | 1.00[0.99–1.00] |
| AST (U/L) [median, IQR] | 52.00[34.00–89.00] | 40.00[32.00–58.00] | 0.308 | 1.00[0.99–1.00] |
| Serum creatinin (mg/dL) [median, IQR] | 0.90[0.60–1.50] | 0.70[0.60–0.90] | 0.030 | 1.51[1.04–2.19] |
| D-Dimer (μg/mL) [median, IQR] | 831.00[483.00–2745.00] | 842.00[348.00–1850.00] | 0.689 | 1.00[1.00–1.00] |
| Fibrinogen (mg/dL) [median, IQR] | 452.00[317.00–581.00) | 452.00[333.00–577.00] | 0.859 | 1.00[0.99–1.00] |
| CRP (mg/L) [median, IQR] | 140.30[58.60–248.00] | 71.20[42.00–196.65] | 0.018 | 1.00[1.00–1.01] |
| Blood glucose (mg/dL) [median, IQR] | 170.00[133.00–237.00] | 159.00[128.00–237.00] | 0.291 | 1.00[0.99–1.01] |
| BMI (kg/m2) [median, IQR] | 28.00[24.00–34.80] | 26.10[22.70–30.50] | 0.035 | 1.05[1.00–1.11] |
| WBC (x1000/mm3) [median, IQR] | 17.60 [13.00–40.00] | 16.00 [11.60–25.70] | 0.047 | 1.05[1.00–1.10] |
| Procalcitonin (ng/mL) [median, IQR] | 0.50[0.50–1.00] | 0.50[0.50–0.50] | 0.115 | 1.12[0.97–1.28] |
| Comorbidities | ||||
| Cardiac disease [n, %] | 99(55.31) | 20(35.09) | 0.007 | 2.29[1.23–4.25] |
| Hypertension [n, %] | 132(73.74) | 29(50.88) | 0.001 | 2.71[1.46–5.02] |
| Cronic respiratory disease [n, %] | 24(13.41) | 8(14.04) | 0.904 | 0.95[0.40–2.46] |
| Chronic kidney disease [n, %] | 19(10.61) | 2(3.51) | 0.116 | 3.26[0.74–14.47] |
| Neurological/ neuromuscular disease [n, %] | 31(17.32) | 8(14.04) | 0.561 | 1.28[0.55–2.98] |
| Peptic ulcer disease [n, %] | 1(0.56) | 1(1.75) | 0.425 | 0.31[0.02–5.11] |
| Coagulopathy [n, %] | 8(4.47) | 1(1.75) | 0.691 | 2.62[0.32–21.41] |
| Diabetes [n, %] | 58(32.40) | 22(38.60) | 0.389 | 0.76[0.41–1.42] |
| Liver disease [n, %] | 27(15.08) | 4(7.02) | 0.175 | 2.35[0.78–7.04] |
| Pregnancy [n, %] | 1(0.56) | 0(0) | 1.00 | ND |
| Postpartum [n, %] | 2(1.12) | 0(0) | 1.00 | ND |
| Imunodeficiency [n, %] | 4(2.23) | 1(1.75) | 1.00 | 1.28[0.14–11.69] |
| Autoimune disease [n, %] | 14(7.82) | 4(7.02) | 1.00 | 1.12[0.35–3.56] |
| Obesity [n, %] | 71(39.66) | 15(26.32) | 0.068 | 1.84[0.95–3.57] |
| Overweight [n, %] | 45(25.14) | 15(26.32) | 0.859 | 0.94[0.48–1.86] |
| Oncological disease [n, %] | 22(12.29) | 3(5.26) | 0.214 | 2.52[0.73–8.76] |
| Psychiatric patology [n, %] | 6(3.35) | 2(3.51) | 1.00 | 0.95[0.19–4.86] |
| Urinary catheterization [n, %] | 179(100) | 57(100) | / | ND |
| CVC [n, %] | 169(94.41) | 30(52.63) | <0.001 | 15.21[6.68–34,63] |
| Peripheral venous catheterization [n, %] | 76(42.46) | 41(71.93) | <0.001 | 0.29[0.15–0.55] |
| Diaysis [n, %] | 31(17.32) | 1(1.75) | 0.001 | 11.73[1.56–87.98] |
| Gastrostomy [n, %] | 1(0.56) | 0(0) | 1.00 | ND |
| Enteral nutrition [n, %] | 173(96.65) | 48(84.21) | <0.001 | 5.41[1.83–15.94] |
| Tracheostomy [n, %] | 3(1.68) | 0(0) | 1.00 | ND |
| Without antibiotherapy [n, %] | 10(5.58) | 6(10.52) | 0.196 | 0.50[0.17–1.45] |
Notes: *APACHE II (“Acute Physiology and Chronic Health Evaluation II”) is a severity-of-disease classification system which is applied to a patient admitted into the ICU during the first 24 hours. It ranges from 0 to 71 and is based on multiple measurements. The higher the score, the more severe the disease and the risk of death increases. 12 admission physiologic variables, the patient’s age and chronic health status are used to compute the score.17 **Carmeli’s score is a marker related both to age, comorbidities and to contact with the hospital environment and can be used for assessing the expected sensitivity to antibiotics in bacterial infections.18 ***The Charlson comorbidity index predicts the 1 year mortality of patients with a wide range of comorbidities. The score sums up 19 comorbidities weighted according to severity. The higher the score, the higher the mortality.19
Abbreviations: n, number; CVC, central venous catheter; ALT, alanine transaminase; AST, aspartate aminotransferase; ARDS, acute respiratory distress syndrome, CRP, C reactive protein; BMI, body mass index; WBC, white blood cells; ND, not defined.