Baseline characteristics, level of disease severity and outcomes of patients with COVID-19 admitted to intensive care unit in COVID-19 dedicated Mugda Medical College and Hospital, Dhaka, Bangladesh

Abstract

Background: Novel coronavirus disease is associated with highly intensive care unit (ICU) mortality. With the dramatic increase of confirmed cases as well as death toll in Bangladesh, timely and effective management of severely and critically ill patients appears to be particularly important. This includes streamlining workflows for rapid diagnosis and isolation, clinical management, and infection prevention. The main objective of this study was identification of the demographic, clinical characteristics, severity and outcome of patients admitted into ICU. Methods: We aimed to describe the demographic and clinical characteristics, severity of disease, management patterns and outcomes of critically ill patients with coronavirus disease 2019 admitted to ICU in a Bangladeshi setting and for this purpose a retro-prospective study of conveniently selected 63 ICU admitted patients with COVID-19 was conducted from May 1 to June 30, 2020. Data were obtained from patient charts and the hospitals’ records using a structured questionnaire. Results: Most of the ICU patients were older male (30, 65.3%) and most of them were 70 or above years of age group (17, 37.0%). ICU patients more likely suffered from comorbidities like hypertension (938, 60.3%); diabetes (36, 57.1%); chronic kidney disease (21, 33.3%). In most cases treatment in ICU included the administration of antibiotics (100.0%) (Meropenem, 20, 31.7%). Forty-Eight patients died (discharge mortality, 76.2%), and fourteen patients were discharged alive from the ICU with a rate of 22.2%. One patient transferred (Palliative discharge, 1.6%) to other facilities for palliative care purpose.Conclusions: Our findings also highlight the importance of planning for mass critical care along with central oxygen supply system as the need for ICU care and ventilator support to treat patients with COVID-19 grows rapidly in Bangladesh.

Outcome of Instrumental Oxygen Therapy in COVID-19: Survivors Versus Non-survivors in Bangladeshi Cohort

“…In the present study, the highest percentage of patients had shortness of breath among survivors (92.3%) and non-survivor (81.66%) in COVID-19 patients admitted in ICU followed by fever, cough, lethargy, and others (anosmia, myalgia, loss of taste, diarrhea, and sore throat). Other studies in Bangladesh also revealed similar findings with shortness of breath accounted for 92.1% [13]. In another study by Rawshan et al also reported shortness of breath as the commonest (86.42%) symptom among 81 critical COVID-19 patients in ICU [19].…”

“…The mortality rate of COVID-19 patients in ICU was almost similar in China, Italy, and Denmark with 37.7%, 25.6%, and 41.2% respectively in different studies [12]. In a previous study on 58 patients in ICU, Nasir et al reported a 44.8% mortality rate 5 and Hossain et al reported a high mortality rate of 76.2% in two different COVID-dedicated hospitals in Dhaka, Bangladesh [13]. In the UK, a study on 690 ICU admitted patients reported a 50.1% of mortality rate in ICU [14].…”

“…Nasir et al reported in a study on 58 patients admitted in ICU, most of the critically ill patients were in the age range of 40-69 years [5]. But in another study in Bangladesh revealed that 28.6% of patients admitted in ICU were in the age range of 60-69 and more than 70 years [13]. Age and other general profiles of the patients may have influenced the prognosis of the patients.…”

Comprehensive Overview of 473 Cases of COVID-19: Outcome Experiences of a Dedicated Hospital in Dhaka, Bangladesh

“…Other observational studies of Bangladesh 22,23,24 , and china 7,14 support similar findings. In our study, mild category patients present with a lower percentage of co-morbid conditions than moderate to critical ones.…”

“…Anosmia was absent in the critical group. Several studies in Bangladesh 19,20,22,23 and worldwide 7,14 show patients with similar symptoms.…”