In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 12 ( 2022-12-30), p. e0279565-
Abstract:
Over 130 million people have been diagnosed with Coronavirus disease 2019 (COVID-19), and more than one million fatalities have been reported worldwide. South Africa is unique in having a quadruple disease burden of type 2 diabetes, hypertension, human immunodeficiency virus (HIV) and tuberculosis, making COVID-19-related mortality of particular interest in the country. The aim of this study was to investigate the clinical characteristics and associated mortality of COVID-19 patients admitted to an intensive care unit (ICU) in a South African setting. Methods and findings We performed a prospective observational study of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection admitted to the ICU of a South African tertiary hospital in Cape Town. The mortality and discharge rates were the primary outcomes. Demographic, clinical and laboratory data were analysed, and multivariable robust Poisson regression model was used to identify risk factors for mortality. Furthermore, Cox proportional hazards regression model was performed to assess the association between time to death and the predictor variables. Factors associated with death (time to death) at p-value 〈 0.05 were considered statistically significant. Of the 402 patients admitted to the ICU, 250 (62%) died, and another 12 (3%) died in the hospital after being discharged from the ICU. The median age of the study population was 54.1 years (IQR: 46.0–61.6). The mortality rate among those who were intubated was significantly higher at 201/221 (91%). After adjusting for confounding, multivariable robust Poisson regression analysis revealed that age more than 48 years, requiring invasive mechanical ventilation, HIV status, procalcitonin (PCT), Troponin T, Aspartate Aminotransferase (AST), and a low pH on admission all significantly predicted mortality. Three main risk factors predictive of mortality were identified in the analysis using Cox regression Cox proportional hazards regression model. HIV positive status, myalgia, and intubated in the ICU were identified as independent prognostic factors. Conclusions In this study, the mortality rate in COVID-19 patients admitted to the ICU was high. Older age, the need for invasive mechanical ventilation, HIV status, and metabolic acidosis were found to be significant predictors of mortality in patients admitted to the ICU.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0279565
DOI:
10.1371/journal.pone.0279565.g001
DOI:
10.1371/journal.pone.0279565.g002
DOI:
10.1371/journal.pone.0279565.g003
DOI:
10.1371/journal.pone.0279565.t001
DOI:
10.1371/journal.pone.0279565.t002
DOI:
10.1371/journal.pone.0279565.t003
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10.1371/journal.pone.0279565.t004
DOI:
10.1371/journal.pone.0279565.t005
DOI:
10.1371/journal.pone.0279565.t006
DOI:
10.1371/journal.pone.0279565.s001
DOI:
10.1371/journal.pone.0279565.s002
DOI:
10.1371/journal.pone.0279565.s003
DOI:
10.1371/journal.pone.0279565.s004
DOI:
10.1371/journal.pone.0279565.s005
DOI:
10.1371/journal.pone.0279565.s006
DOI:
10.1371/journal.pone.0279565.r001
DOI:
10.1371/journal.pone.0279565.r002
DOI:
10.1371/journal.pone.0279565.r003
DOI:
10.1371/journal.pone.0279565.r004
DOI:
10.1371/journal.pone.0279565.r005
DOI:
10.1371/journal.pone.0279565.r006
DOI:
10.1371/journal.pone.0279565.r007
DOI:
10.1371/journal.pone.0279565.r008
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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