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Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study

BACKGROUND: The coronavirus disease (COVID-19) pandemic has severely affected African countries, specifically the countries, such as Libya, that are in constant conflict. Clinical and laboratory information, including mortality and associated risk factors in relation to hospital settings and availab...

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Autores principales: Elhadi, Muhammed, Alsoufi, Ahmed, Abusalama, Abdurraouf, Alkaseek, Akram, Abdeewi, Saedah, Yahya, Mohammed, Mohammed, Alsnosy, Abdelkabir, Mohammed, Huwaysh, Mohammed, Amkhatirah, Emad, Alshorbaji, Kamel, Khel, Samer, Gamra, Marwa, Alhadi, Abdulmueti, Abubaker, Taha, Anaiba, Mohamed, Elmugassabi, Mohammed, Binnawara, Muhannud, Khaled, Ala, Zaid, Ahmed, Msherghi, Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087095/
https://www.ncbi.nlm.nih.gov/pubmed/33930079
http://dx.doi.org/10.1371/journal.pone.0251085
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author Elhadi, Muhammed
Alsoufi, Ahmed
Abusalama, Abdurraouf
Alkaseek, Akram
Abdeewi, Saedah
Yahya, Mohammed
Mohammed, Alsnosy
Abdelkabir, Mohammed
Huwaysh, Mohammed
Amkhatirah, Emad
Alshorbaji, Kamel
Khel, Samer
Gamra, Marwa
Alhadi, Abdulmueti
Abubaker, Taha
Anaiba, Mohamed
Elmugassabi, Mohammed
Binnawara, Muhannud
Khaled, Ala
Zaid, Ahmed
Msherghi, Ahmed
author_facet Elhadi, Muhammed
Alsoufi, Ahmed
Abusalama, Abdurraouf
Alkaseek, Akram
Abdeewi, Saedah
Yahya, Mohammed
Mohammed, Alsnosy
Abdelkabir, Mohammed
Huwaysh, Mohammed
Amkhatirah, Emad
Alshorbaji, Kamel
Khel, Samer
Gamra, Marwa
Alhadi, Abdulmueti
Abubaker, Taha
Anaiba, Mohamed
Elmugassabi, Mohammed
Binnawara, Muhannud
Khaled, Ala
Zaid, Ahmed
Msherghi, Ahmed
author_sort Elhadi, Muhammed
collection PubMed
description BACKGROUND: The coronavirus disease (COVID-19) pandemic has severely affected African countries, specifically the countries, such as Libya, that are in constant conflict. Clinical and laboratory information, including mortality and associated risk factors in relation to hospital settings and available resources, about critically ill patients with COVID-19 in Africa is not available. This study aimed to determine the mortality and morbidity of COVID-19 patients in intensive care units (ICU) following 60 days after ICU admission, and explore the factors that influence in‐ICU mortality rate. METHODS: This is a multicenter prospective observational study among COVID-19 critical care patients in 11 ICUs in Libya from May 29th to December 30th 2020. Basic demographic data, clinical characteristics, laboratory values, admission Sequential Organ Failure Assessment (SOFA) score, quick SOFA, and clinical management were analyzed. RESULT: We included 465 consecutive COVID-19 critically ill patients. The majority (67.1%) of the patients were older than 60 years, with a median (IQR) age of 69 (56.5–75); 240 (51.6%) were male. At 60 days of follow-up, 184 (39.6%) were discharged alive, while 281 (60.4%) died in the intensive care unit. The median (IQR) ICU length of stay was 7 days (4–10) and non-survivors had significantly shorter stay, 6 (3–10) days. The body mass index was 27.9 (24.1–31.6) kg/m2. At admission to the intensive care unit, quick SOFA median (IQR) score was 1 (1–2), whereas total SOFA score was 6 (4–7). In univariate analysis, the following parameters were significantly associated with increased/decreased hazard of mortality: increased age, BMI, white cell count, neutrophils, procalcitonin, cardiac troponin, C-reactive protein, ferritin, fibrinogen, prothrombin, and d-dimer levels were associated with higher risk of mortality. Decreased lymphocytes, and platelet count were associated with higher risk of mortality. Quick SOFA and total SOFA scores increase, emergency intubation, inotrope use, stress myocardiopathy, acute kidney injury, arrythmia, and seizure were associated with higher mortality. CONCLUSION: Our study reported the highest mortality rate (60.4%) among critically ill patients with COVID-19 60 days post-ICU admission. Several factors were found to be predictive of mortality, which may help to identify patients at risk of mortality during the ongoing COVID-19 pandemic.
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spelling pubmed-80870952021-05-06 Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study Elhadi, Muhammed Alsoufi, Ahmed Abusalama, Abdurraouf Alkaseek, Akram Abdeewi, Saedah Yahya, Mohammed Mohammed, Alsnosy Abdelkabir, Mohammed Huwaysh, Mohammed Amkhatirah, Emad Alshorbaji, Kamel Khel, Samer Gamra, Marwa Alhadi, Abdulmueti Abubaker, Taha Anaiba, Mohamed Elmugassabi, Mohammed Binnawara, Muhannud Khaled, Ala Zaid, Ahmed Msherghi, Ahmed PLoS One Research Article BACKGROUND: The coronavirus disease (COVID-19) pandemic has severely affected African countries, specifically the countries, such as Libya, that are in constant conflict. Clinical and laboratory information, including mortality and associated risk factors in relation to hospital settings and available resources, about critically ill patients with COVID-19 in Africa is not available. This study aimed to determine the mortality and morbidity of COVID-19 patients in intensive care units (ICU) following 60 days after ICU admission, and explore the factors that influence in‐ICU mortality rate. METHODS: This is a multicenter prospective observational study among COVID-19 critical care patients in 11 ICUs in Libya from May 29th to December 30th 2020. Basic demographic data, clinical characteristics, laboratory values, admission Sequential Organ Failure Assessment (SOFA) score, quick SOFA, and clinical management were analyzed. RESULT: We included 465 consecutive COVID-19 critically ill patients. The majority (67.1%) of the patients were older than 60 years, with a median (IQR) age of 69 (56.5–75); 240 (51.6%) were male. At 60 days of follow-up, 184 (39.6%) were discharged alive, while 281 (60.4%) died in the intensive care unit. The median (IQR) ICU length of stay was 7 days (4–10) and non-survivors had significantly shorter stay, 6 (3–10) days. The body mass index was 27.9 (24.1–31.6) kg/m2. At admission to the intensive care unit, quick SOFA median (IQR) score was 1 (1–2), whereas total SOFA score was 6 (4–7). In univariate analysis, the following parameters were significantly associated with increased/decreased hazard of mortality: increased age, BMI, white cell count, neutrophils, procalcitonin, cardiac troponin, C-reactive protein, ferritin, fibrinogen, prothrombin, and d-dimer levels were associated with higher risk of mortality. Decreased lymphocytes, and platelet count were associated with higher risk of mortality. Quick SOFA and total SOFA scores increase, emergency intubation, inotrope use, stress myocardiopathy, acute kidney injury, arrythmia, and seizure were associated with higher mortality. CONCLUSION: Our study reported the highest mortality rate (60.4%) among critically ill patients with COVID-19 60 days post-ICU admission. Several factors were found to be predictive of mortality, which may help to identify patients at risk of mortality during the ongoing COVID-19 pandemic. Public Library of Science 2021-04-30 /pmc/articles/PMC8087095/ /pubmed/33930079 http://dx.doi.org/10.1371/journal.pone.0251085 Text en © 2021 Elhadi et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Elhadi, Muhammed
Alsoufi, Ahmed
Abusalama, Abdurraouf
Alkaseek, Akram
Abdeewi, Saedah
Yahya, Mohammed
Mohammed, Alsnosy
Abdelkabir, Mohammed
Huwaysh, Mohammed
Amkhatirah, Emad
Alshorbaji, Kamel
Khel, Samer
Gamra, Marwa
Alhadi, Abdulmueti
Abubaker, Taha
Anaiba, Mohamed
Elmugassabi, Mohammed
Binnawara, Muhannud
Khaled, Ala
Zaid, Ahmed
Msherghi, Ahmed
Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study
title Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study
title_full Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study
title_fullStr Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study
title_full_unstemmed Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study
title_short Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study
title_sort epidemiology, outcomes, and utilization of intensive care unit resources for critically ill covid-19 patients in libya: a prospective multi-center cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087095/
https://www.ncbi.nlm.nih.gov/pubmed/33930079
http://dx.doi.org/10.1371/journal.pone.0251085
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