Characteristics of mechanically ventilated COVID-19 patients in the Al-Ahsa Region of Saudi Arabia: a retrospective study with survival analysis

Ann Saudi Med. 2022 May-Jun;42(3):165-173. doi: 10.5144/0256-4947.2022.165. Epub 2022 Jun 2.

Abstract

Background: About 5-10% of coronavirus disease 2019 (COVID-19) infected patients require critical care hospitalization and a variety of respiratory support, including invasive mechanical ventilation. Several nationwide studies from Saudi Arabia have identified common comorbidities but none were focused on mechanically ventilated patients in the Al-Ahsa region of Saudi Arabia.

Objectives: Identify characteristics and risk factors for mortality in mechanically ventilated COVID-19 patients.

Design: Retrospective chart review SETTING: Two general hospitals in the Al-Ahsa region of Saudi Arabia PATIENTS AND METHODS: We included mechanically ventilated COVID-19 patients (>18 years old) admitted between 1 May and 30 November 2020, in two major general hospitals in the Al-Ahsa region, Saudi Arabia. Descriptive statistics were used to characterize patients. A multivariable Cox proportional hazards (CPH) model was used exploratively to identify hazard ratios (HR) of predictors of mortality.

Main outcome measures: Patient characteristics, mortality rate, extubation rate, the need for re-intubation and clinical complications during hospitalization.

Sample size and characteristics: 154 mechanically ventilated COVID-19 patients with median (interquartile range) age of 60 (22) years; 65.6% male.

Results: Common comorbidities were diabetes (72.2%), hypertension (67%), cardiovascular disease (14.9%) and chronic kidney disease (CKD) (14.3%). In the multivariable CPH model, age >60 years old (HR=1.83, 95% CI 1.2-2.7, P=.002), CKD (1.61, 95% CI 0.9-2.6, P=.062), insulin use (HR=0.65, 95% CI 0.35-.08, P<.001), and use of loop diuretics (HR=0.51, 95% CI 0.4, P=.037) were major predictors of mortality.

Conclusion: Common diseases in mechanically ventilated COVID-19 patients from the Al-Ahsa region were diabetes, hypertension, other cardiovascular diseases, and CKD in this exploratory analysis.

Limitations: Retrospective, weak CPH model performance.

Conflicts of interest: None.

MeSH terms

  • Adolescent
  • COVID-19* / epidemiology
  • COVID-19* / therapy
  • Diabetes Mellitus*
  • Female
  • Humans
  • Hypertension* / epidemiology
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic*
  • Respiration, Artificial
  • Retrospective Studies
  • Saudi Arabia / epidemiology
  • Survival Analysis

Grants and funding

None.