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

Authors

  • Irin Hossain Department of Occupational and Environmental Health, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh
  • Manzurul H. Khan Centres for Disease Control and Prevention, Directorate General of Health Services, Dhaka, Bangladesh
  • Shah G. Tuhin Mugda Medical College, Dhaka, Bangladesh
  • M. M. Aktaruzzaman Dhaka Medical College, Dhaka, Bangladesh
  • Shafiur Rahman Department of Occupational and Environmental Health, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh
  • Ashekur R. Mullick Department of Occupational and Environmental Health, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh
  • Md. Shahin Department of Occupational and Environmental Health, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh
  • Nahid Yasmin Department of Gynae and Obstetrics, Mugda Medical College, Dhaka, Bangladesh
  • Adnan Y. Choudhury Department of Respiratory Medicine, Mugda Medical College, Dhaka, Bangladesh
  • Monjurul Haque Department of Respiratory Medicine, Mugda Medical College, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20204347

Keywords:

Baseline characteristics, Disease severity, Patient’s outcome, Intensive care unit, COVID-19 pandemic

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.  

Author Biography

Irin Hossain, Department of Occupational and Environmental Health, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh

Data Enumerator, NIPSOM

References

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of 2019 novel coronavirus infection in China. medRxiv. 2020

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lanc. 2020;395:497-506.

Coronavirus disease (COVID-19) pandemic, The World Health Organization (WHO), available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed on 10 June 2020.

Novel Corona Virus 2019 Update, World-O-Meter, Available at: https://www. worldometers.info/. Accessed on 02 July 2020

Daily Live Updates of Corona Virus: Aljazeera Television, Available at: https://www.aljazeera.com /news/2020/06/eu-bar-travellers-brazil-coronavirus-live-updates-200627002953075.html. Accessed on 02 July 2020.

Coronavirus India Live Updates, The India Express, Available at: https://indianexpress.com/article/ india/coronavirus-india-news-live-updates-covid-19-tracker-corona-cases-in-india-today-update-lockdown-extension-state-wise-latest-news-tamil-nadu-delhi-6479588/. Accessed on 02 July 2020.

WHO director-general’s opening remarks at the media briefing on COVID-19-11 March 2020. Geneva: World Health Organization. Available at: www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at -the-media-briefing-on-covid-19---11-march-2020. Accessed 11 March 2020.

Wadhera RK et al. Variation in COVID-19 hospitalizations and deaths across New York City boroughs. JAMA. 2020;323(21):2192.

Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. J Americ Medi Assoc. 2020;1-8.

Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lanc Respirat Medici. 2020.

Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW. Presenting Characteristics. Comorbidities, and Outcomes Among. 2020;5700.

Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3):105924.

Qiu H, Tong Z, Ma P, Hu M, Peng Z, Wu W, et al. Intensive care during the coronavirus epidemic. Intensi Care Med. 2020;46:576-78

ICU Care Management Challenges and Recommendations for COVID-19, Infectious Disease Advisor, Available at: https://www .infectiousdiseaseadvisor.com/home/topics/covid19 /icu-care-management-challenges-and-recommen dations-for-covid-19/ Accessed on: 19 July 2020

Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. Briti J Medic. 2020;369.

Fei Zhou (2020) Clinical Course and Risk Factors for Mortality of Adult in Patients with COVID-19 in Wuhan, China: A Retrospective Cohort Study. J Med Stud Res. 3:015.

The World Health Organization (WHO), Inspire: A New Perspective on Respiratory Rate Monitoring. Available at: https://www.who.int/medical_devices/ Sat_pm_INN_7_SCRIPT .pdf?ua=1. Accessed on 03 June 2020.

The World Health Organization (WHO), Pulse Oximetry Training Manual. Available at: https://www.who.int/patientsafety/safesurgery/pulse oximetry/whopspulse_oxymetry_training_manual_en.pdf?ua=1. Accessed on 10 June 2020.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. J Americ Medic Assoc. 2020.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lanc. 395: 507-13.

Walker M., High Mortality Rate in Intubated COVID-19 Patients in NYC (2020), Medpage Today. Available at: https://www.medpagetoday. com/infectiousdisease/covid19 /86101. Accessed on 05 May 2020.

Covid-19 in the UK: intensive care survival rate, Available at: https://www.statista .com/chart/ 21360/uk-intensive-care-covid-19-survival-rate/. Accessed on 20 July 2020.

Touret F, de Lamballerie X. Of chloroquine and COVID-19. Antivir Res. 2020 177:104762.

Yao X, Ye F, Zhang M, Cui C, Huang B, Niu P, et al. In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clinic Infecti Diseas. 2020.

World Health Organization. Novel coronavirus- China. Available at: http://www.who.int/csr/ don/12–january-2020-novel-coronavirus-china/en/. Accessed on 12 May 2020.

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Published

2020-09-25

How to Cite

Hossain, I., Khan, M. H., Tuhin, S. G., Aktaruzzaman, M. M., Rahman, S., Mullick, A. R., Shahin, M., Yasmin, N., Choudhury, A. Y., & Haque, M. (2020). 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. International Journal Of Community Medicine And Public Health, 7(10), 3837–3842. https://doi.org/10.18203/2394-6040.ijcmph20204347

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Original Research Articles