Assessment of Clinical Characteristics and Mortality-Associated Factors in COVID-19 Critical Cases in Kuwait

Abstract

Objective: The objective of this study was to assess the clinical characteristics and identify mortality risk factors in intensive care unit (ICU)-admitted COVID-19 patients. Methods: We recruited and analyzed SARS-CoV-2-infected adult patients (age ≥18 years) who were admitted to the ICU at Jaber Al-Ahmad Al Sabah Hospital, Kuwait, between March 1, 2020, and April 30, 2020. The risk factors associated with in-hospital mortality were assessed using multiple regression analysis. Results: We recruited a total of 103 ICU patients in this retrospective cohort. The median age of the patients was 53 years and the fatality rate was 45.6%; majority (85.5%) were males and 37% patients had more than 2 comorbidities. Preexisting hypertension, moderate/severe acute respiratory distress syndrome, lymphocyte count <0.5 × 109, serum albumin <22 g/L, procalcitonin >0.2 ng/mL, D-dimer >1,200 ng/mL, and the need for continuous renal replacement therapy were significantly associated with mortality. Conclusion: This study describes the clinical characteristics and risk factors for mortality among ICU patients with COVID-19. Early identification of risk factors for mortality might help improve outcomes.

SciScore for 10.1101/2020.06.17.20134007: (What is this?)

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

Table 1: Rigor

Institutional Review Board Statement	not detected.
Randomization	not detected.
Blinding	not detected.
Power Analysis	not detected.
Sex as a biological variable	not detected.

Table 2: Resources

No key resources detected.

Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:

There were several limitations of our study. Firstly, the sample size in our study was relatively small. Recruitment of a higher number of patients could have provided a clearer picture. Secondly, the patient data was collected retrospectively from their electronic records, which often had incomplete information. This could lead to information bias. Thirdly, there was no standard protocol for laboratory workup of the patients during ICU admission. This led to the absence of the results of some laboratory tests for some patients. Due to this, the laboratory-based data for some patients could not be included in the regression model, which might lead to discrepancy with respect to mortality predictors. Finally, at the end of the follow-up period, 11 patients were still in ICU, among which six were intubated, and one was on ECMO. This could again lead to bias in our final analysis as the mortality among these patients remained undefined. We propose for the future studies to recruit higher number of patients and to follow them up for a longer duration to further elucidate the factors that contribute to mortality among the COVID-19 patients.

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:

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Assessment of Clinical Characteristics and Mortality-Associated Factors in COVID-19 Critical Cases in Kuwait

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