Mortality Rate and Associated Factors in Critically Ill Intubated Patients with Coronavirus Disease 2019 (COVID-19) at Pranangklao Hospital

Abstract

Introduction: In the epidemic wave of the ongoing coronavirus disease 2019 (COVID-19) pandemic in April 2021. This study aimed to explore the 30-day mortality rate and its associated factors and anesthetic practice in critically ill COVID-19 patients who received intubation.
Methods: This retrospective cohort study was collected data from medical records in critically ill COVID-19 patients who received intubation and admitted to Pranangklao Hospital (PNKH) from April 1 to June 30, 2021.
Results: A total of 73 patients were admitted and intubated with the median age was 65 years (IQR = 18), 43 (58.9%) were male, 37 (50.7%) were body mass index (BMI) ≥ 30 kg/m², and 60 (82.2%) had underlying diseases. The most common underlying diseases were hypertension (63.00%) and diabetes (47.90%). The 30-day mortality rate was 79.50%. Compared between the survivors (n = 15) and non-survivors (n = 58), the mortality significantly increased with age (P = .002), more underlying diseases (P = .007), having cough (RR_adj 31.90, 95% CI = 1.67-610.65, P = .021), and more complications (RR_adj 2.58, 95% CI = 1.02-6.51, P = .045). The anesthetics were used as follows: midazolam (80.95%), thiopental (40.48%), propofol (26.19%), and ketamine (23.81%). The muscle relaxants used in intubation included succinylcholine (90.48%) and rocuronium (9.52%).
Conclusions: Critically ill intubated COVID-19 patients showed a very high mortality rate that significantly increased with age, underlying diseases, and complications. Intubation treatment in vulnerable populations should be done cautiously to avoid adverse events.