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

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.