Characteristics, Management And Outcomes Of Critically Ill Covid-19 Patients Admitted To Icu In Hospitals In Bangladesh: A Retrospective Study

  1. Ayan Saha
  2. Mohammad Moinul Ahsan
  3. Tarek-Ul-Quader
  4. Mohammad Umer Sharif Shohan
  5. Sabekun Naher
  6. Preya Dutta
  7. Al-Shahriar Akash
  8. H M Hamidullah Mehedi
  9. A S M Arman Ullah Chowdhury
  10. Hasanul Karim
  11. Tazrina Rahman
  12. Ayesha Parvin

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Abstract

Objectives

This study aimed to analyse the epidemiological and clinical characteristics of critical COVID-19 cases and investigate risk factors including comorbidities and age in relation with the clinical aftermath of COVID-19 in critical cases in Bangladesh.

Methods

In this retrospective study, epidemiological and clinical characteristics, complications, laboratory results, and clinical management of the patients were studied from data obtained from 168 individuals diagnosed with an advanced prognosis of COVID-19 admitted in two hospitals in Bangladesh.

Results

Individuals in the study sample contracted COVID-19 through community transmission. 56.5% (n = 95) cases died in intensive care units (ICU) during the study period. The median age was 56 years and 79.2% (n=134) were male. Typical clinical manifestation included Acute respiratory distress syndrome (ARDS) related complications (79.2%), fever (54.2%) and cough (25.6%) while diabetes mellitus (52.4%), hypertension (41.1%) and heart diseases (16.7%) were the conventional comorbidities. Clinical outcomes were detrimental due to comorbidities rather than age and comorbid individuals over 50 were at more risk. In the sample, oxygen saturation was low (< 95% SpO2) in 135 patients (80.4%) and 158 (93.4%) patients received supplemental oxygen. Identical biochemical parameters were found in both deceased and surviving cases. Administration of antiviral drug Remdesivir and the glucocorticoid, Dexamethasone increased the proportion of surviving patients slightly.

Conclusions

Susceptibility to developing critical illness due to COVID-19 was found more in comorbid males. These atypical patients require more clinical attention from the prospect of controlling mortality rate in Bangladesh.

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    SciScore for 10.1101/2020.09.24.20201285: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This study was approved by the IRB of the Chattogram General Hospital Ethics Committee and the patients gave oral consent regarding data collection and usage.
    Consent: This study was approved by the IRB of the Chattogram General Hospital Ethics Committee and the patients gave oral consent regarding data collection and usage.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    R-script and GraphPad Prism version 7.04 was used to perform all of the statistical analyses and the figure plotting.
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: Thank you for sharing your code.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Although the findings of this study were significant, limitations were also in order. Firstly, laboratory data collection to conduct a broad and extensive study was inevitably challenging as the laboratory results were not systematically collected. Secondly, the evaluated data was extracted retrospectively from patients’ medical files and not all laboratory tests were conducted on all patients. Thirdly, because of the study’s objective to identify the critical care needs of patients with the greatest severity of illness, the sample size is small. Therefore, more thorough assessment of comorbidities in larger samples of critical Bangladeshi patients with COVID-19 and future studies are required. Despite these limitations, this study represented the largest cohort of critically ill COVID-19 patients from Bangladesh reported to date.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  2. Version published to 10.1101/2020.09.24.20201285v1 on medRxiv