Clinical Profile and Short-term Outcomes of COVID-19 Patients in a Dedicated Intensive Care Unit of Bangladesh: A Single Centre Experience

Abstract

Introduction: The COVID-19 pandemic emerged as a major public health crisis and was confirmed to havespread to Bangladesh since March 2020. A large number of hospitalized patients with COVID-19 pneumoniarequire intensive care for respiratory support due to hypoxic respiratory failure. Bangladesh is greatlyfacing multiple challenges to combat the surging pandemic due to lack of experiences and insufficientmedical resources. Reports describing patients admitted to the ICU with COVID-19 in Bangladesh are verylimited. Objective of this study was to determine the clinical characteristics and outcomes of the COVID-19patients admitted at the dedicated intensive care unit of Kurmitola General Hospital, Dhaka for bettercharacterization of COVID-19 infection in critically ill patients in a resource limited setting. Materials and Methods: All the RT-PCR confirmed COVID-19 patients aged >15 years who had beenadmitted to the dedicated COVID intensive care unit of Kurmitola General Hospital, Dhaka from April2020 to October 2020 were included in this retrospective cross-sectional study. The protocol was approvedby the Ethical and Scientific Committee of the institute. The demographic, clinical and treatment data ofall participants were collected and evaluated and mode of treatments were compared between survivorand non-survivor groups. The statistical analysis was carried out using the Statistical Package for SocialSciences version 22.0 for Windows (SPSS Inc., Chicago, Illinois, USA). Results: A total of 294 critically ill COVID-19 patients were admitted to the ICU of Kurmitola generalhospital between April, 2020 to October, 2020. The mean (±SD) age of the patients was 57.4 (±13.1) years,male participants were predominant (71.1%), 74.5% patients had positive contact history, commonpresenting problems were fever (94.5%), cough (83.6%), dyspnoea (80.9%), diarrhoea (60.2%) and chestpain (42.8%). Frequency of different associated co-morbidities like hypertension (49.3%), diabetes mellitus(50.3%), cardiac diseases (34.0%), renal diseases (17.7%), bronchial asthma (33.3%), COPD (40.1%), CVD(24.1%) and obesity (24.1%) were high. The mean (±SD) length of ICU stay of the patients was 7.0 (±4.1)days; 11.6% patients required mechanical ventilation; 63.6% of ICU patients died and 36.4% recovered inthe specified time period. HFNC was provided to 62.6% patients in survivor group and 56.1% in nonsurvivorgroup, 31% of non-survivor patients required non-invasive ventilator support. Requirement ofmechanical ventilation was significantly higher among the non-survivor group (18.7%) than survivorgroup (p

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孟加拉国专用重症监护室COVID-19患者的临床概况和短期结果:单一中心经验

导言:2019冠状病毒病大流行已成为一场重大公共卫生危机，并已确认自2020年3月以来已蔓延至孟加拉国。大量新冠肺炎住院患者因缺氧性呼吸衰竭需要重症监护呼吸支持。由于缺乏经验和医疗资源不足，孟加拉国在抗击疫情方面面临多重挑战。关于孟加拉国COVID-19患者入住ICU的报告非常有限。本研究的目的是确定达卡Kurmitola综合医院专用重症监护室收治的COVID-19患者的临床特征和结局，以便在资源有限的情况下更好地表征危重患者的COVID-19感染情况。材料与方法:本回顾性横断面研究纳入2020年4月至2020年10月在达卡Kurmitola综合医院专用重症监护病房收治的所有年龄为bb0 ~ 15岁的RT-PCR确诊的COVID-19患者。该方案得到了研究所伦理与科学委员会的批准。收集和评估所有参与者的人口统计学、临床和治疗数据，并比较存活组和非存活组之间的治疗模式。使用statistical Package for SocialSciences version 22.0 for Windows (SPSS Inc.， Chicago, Illinois, USA)进行统计分析。结果:2020年4月至2020年10月，库米托拉综合医院ICU共收治新冠肺炎危重患者294例。患者平均(±SD)年龄为57.4(±13.1)岁，男性居多(71.1%)，74.5%患者有阳性接触史，常见症状为发热(94.5%)、咳嗽(83.6%)、呼吸困难(80.9%)、腹泻(60.2%)和胸痛(42.8%)。高血压(49.3%)、糖尿病(50.3%)、心脏病(34.0%)、肾脏疾病(17.7%)、支气管哮喘(33.3%)、慢性阻塞性肺病(40.1%)、心血管疾病(24.1%)、肥胖(24.1%)等相关合并症的发生率较高。患者ICU住院时间平均(±SD)为7.0(±4.1)天;11.6%患者需要机械通气;63.6%的ICU患者在规定时间内死亡，36.4%的患者康复。生存组62.6%的患者和非生存组56.1%的患者接受了HFNC治疗，31%的非生存患者需要无创呼吸机支持。非存活组机械通气需要量(18.7%)显著高于存活组(p < 0.01)。恢复期血浆治疗的使用率生存组(29.0%)显著高于非生存组(18.7%)(p=0.043)。两组在抗病毒、单克隆抗体和抗凝治疗方面无显著差异。结论:本回顾性横断面研究反映了达卡Kurmitola综合医院ICU重症COVID-19患者的临床特点和治疗结果，阳性接触史和合并症发生率较高。需要机械通气的患者死亡率显著增高。生存组患者恢复期血浆治疗获益显著。应该进行更大的、多中心的、有长期随访的前瞻性研究来验证研究结果。JBSA 2021;34 (1): 19

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