Demographic Characteristics, Comorbidities, and Length of Stay of COVID-19 Patients Admitted Into Intensive Care Units in Saudi Arabia: A Nationwide Retrospective Study

Abstract

BackgroundThis study aimed to describe the demographic characteristics and determine the risk factors associated with disease severity and length of hospital and intensive care unit (ICU) stay in a cohort of COVID-19 patients admitted into ICU in Saudi Arabia.MethodsThis was a national, multi-center, retrospective cross-sectional study of all COVID-19 cases admitted into different ICUs in Saudi Arabia between March 2020 and September 202l. Demographic, clinical features, comorbidities, and length of stay (LOS) data were retrieved from the national Health Electronic Surveillance Network (HESN) and Taqassi databases at the Saudi Ministry of Health (MOH) for subsequent analyses. We used multiple linear regression models to determine risk factors associated with critical outcomes (including LOS in ICU) among COVID-19 cases.ResultsA total of 12,436 COVID-19 patients were included in this study, with a mean age of 59.57 ± 18.30 years and 7,679 (62%) were <65 years old. COVID-19 was more common in males (N = 7,686, 61.9%) and Saudi nationals (N = 8,516, 68.5%). The clinical characteristic findings showed that 36.3% of patients required invasive ventilation whilst 65.4% received tracheostomies for ventilation, and 4% were on dialysis. Our analysis revealed that 2,978 (23.9%) patients had one comorbidity, 4,977 (47.4%) had two or more comorbidities, and diabetes (48.2%) was the most prevalent comorbidity, followed by hypertension (44.2%), and chronic cardiovascular disease (10.5%). Thirteen variables emerged as significant predictors of LOS in ICU using multiple linear regression analyses, with invasive ventilation as the strongest predictor of LOS in the ICU (beta = −0.68, p = 0.001) and hospital admission (beta = −0.65, p = 0.001).ConclusionsCOVID-19 continues to affect millions of people around the world, with a mortality rate of about 2–3% of all infected patients. Our analysis revealed that comorbidities such as chronic kidney disease, cardiovascular disease, diabetes, and older age were significant risk factors associated with a poorer prognosis and longer duration of stay in hospitals and ICU.

Impact of common comorbidities on antimicrobial consumption and mortality amongst critically ill COVID-19 patients: A retrospective two center study in Saudi Arabia

“…This is the first multicenter study to explore the relationship between comorbidities, antimicrobial consumption and mortality in COVID-19 patients admitted to the ICU in Saudi Arabia. In this study, the ICU mortality was slightly higher than what was previously reported 59.3% vs. 51.8%, respectively ( Al-Otaiby et al, 2022 , Khalid et al, 2022 , Vogels et al, 2021 , Ñamendys-Silva et al, 2021 ). This might be attributed to the difference in clinical characteristics, between our cohort and other patients from other studies, suggesting that there might be a direct relationship between these specific distinctions and mortality.…”

“…The findings by Abohamar and colleagues showed a link between higher mortality rates and diabetes among hospitalized COVID-19 patients in Saudi Arabia ( Abohamr et al, 2020 ). Likewise, more recently, Al-Otaiby and colleagues, found a strong association between diabetes mellitus and mortality among critically ill COVID-19 patients in Saudi Arabia ( Al-Otaiby et al, 2022 ). In fact, pre-existing diabetes was present in more than 80% of fatal COVID-19 cases in a study including elderly patients ( Al-Zahrani, 2021 ).…”

“…The other important finding in our study was the need for mechanical ventilation and vasopressor support. While some reports showed that 82% and 83% of COVID-19 patients require mechanical ventilation and vasopressors, respectively ( Haase et al, 2021 ), others demonstrate a vasopressor use of as high as 90% ( Al-Otaiby et al, 2022 , Ñamendys-Silva et al, 2021 ). In our study, 83% of our population required mechanical ventilation and nearly 60% received vasopressors.…”

“…In a recently published multicenter cross-sectional study of 12,436 critically ill COVID-19 patients admitted to MOH hospitals in Saudi Arabia, clinical characteristics associated with disease severity and length of stay in the ICU and hospital were described. Amongst several reported comorbidities, diabetes mellitus, hypertension, chronic cardiovascular diseases, chronic kidney disease, chronic liver disease, and hemoglobinopathies were associated with higher overall mortality ( Al-Otaiby et al, 2022 ). Moreover, a group of investigators explored the association between clinical characteristics of the disease and ICU mortality.…”

The impact of comorbidities and economic inequality on COVID-19 mortality in Mexico: a machine learning approach

“…Therefore, different prevalence rates of comorbidities in different countries had different effects on the COVID-19 pandemic. For example, in Saudi Arabia, COVID-19 mortality was associated with diabetes, hypertension, and chronic cardiovascular disease (Al-Otaiby et al, 2022 ). Data from Côte d'Ivoire showed that diabetes, hypertension, and obesity were the major comorbidities of COVID-19 deaths in that country (Usui et al, 2022 ).…”