Factors associated with admission to the intensive care unit and mortality in patients with COVID-19, Colombia

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has affected millions of people worldwide, and several sociodemographic variables, comorbidities and care variables have been associated with complications and mortality. OBJECTIVE: To identify the factors associated with admission to intensive care units (ICUs) and mortality in patients with COVID-19 from 4 clinics in Colombia. METHODS: This was a follow-up study of a cohort of patients diagnosed with COVID-19 between March and August 2020. Sociodemographic, clinical (Charlson comorbidity index and NEWS 2 score) and pharmacological variables were identified. Multivariate analyses were performed to identify variables associated with the risk of admission to the ICU and death (p<0.05). RESULTS: A total of 780 patients were analyzed, with a median age of 57.0 years; 61.2% were male. On admission, 54.9% were classified as severely ill, 65.3% were diagnosed with acute respiratory distress syndrome, 32.4% were admitted to the ICU, and 26.0% died. The factors associated with a greater likelihood of ICU admission were severe pneumonia (OR: 9.86; 95%CI:5.99–16.23), each 1-point increase in the NEWS 2 score (OR:1.09; 95%CI:1.002–1.19), history of ischemic heart disease (OR:3.24; 95%CI:1.16–9.00), and chronic obstructive pulmonary disease (OR:2.07; 95%CI:1.09–3.90). The risk of dying increased in those older than 65 years (OR:3.08; 95%CI:1.66–5.71), in patients with acute renal failure (OR:6.96; 95%CI:4.41–11.78), admitted to the ICU (OR:6.31; 95%CI:3.63–10.95), and for each 1-point increase in the Charlson comorbidity index (OR:1.16; 95%CI:1.002–1.35). CONCLUSIONS: Factors related to increasing the probability of requiring ICU care or dying in patients with COVID-19 were identified, facilitating the development of anticipatory intervention measures that favor comprehensive care and improve patient prognosis.