A comparative analysis of clinical, para-clinical, and laboratory factors in ICU and Non-ICU admitted COVID-۱۹ patients: identifying predictive markers for ICU admission

Introduction: Health care systems all over the world face numerous challenges as a result of the rapid spread of the COVID-۱۹ virus that has resulted in increased mortality rates. About ۴۰% of ICU-admitted COVID-۱۹ patients were not severely ill at the time of admission. Thus, by using appropriate ICU admission predictors, clinicians can identify potential critical patients early on. It can also result in suitable resource allocation and consideration for these patients. Therefore, the current study was done with the aim of identifying clinical characteristics and laboratory data that could predict ICU admission in cases with COVID-۱۹.Methods: This two-center retrospective observational study was done in Imam Reza and Ghaem Hospitals, Mashhad, Iran. Overall, ۳۳۴ COVID-۱۹ patients who referred to these hospitals from February to May ۲۰۲۰ were enrolled in this study. The participants were separated into two groups according to ICU admission status. All demographic, clinical, and paraclinical information were extracted from the medical records of the patients. Results: The present study composed of ۸۸ ICU and ۲۴۶ non-ICU-admitted COVID-۱۹ patients. No significant differences were found in age between the two groups of patients (P=۰.۱۵۴). Multivariate regression analysis revealed that higher levels of CRP (OR=۱.۰۱, ۹۵%CI ۱.۰۰۱-۱.۰۱۰, P=۰.۰۱۶), WBC (OR=۱.۱۱, ۹۵% CI ۱.۰۱-۱.۲۲, P=۰.۰۳), and HRCT scores (OR=۱.۰۸, ۹۵%CI=۱.۰۱-۱.۱۶, P=۰.۰۳۷) were linked to higher odds of ICU admission.Conclusion: This study suggests that higher levels of CRP, WBC, and LDH, as well as the HRCT score at the time of admission, were potential independent predictors of ICU admission during inpatient treatment in COVID-۱۹ patients.

Keywords:

COVID-۱۹ , ICU admission , C Reactive Protein , Lactate Dehydrogenase , Predictive marker