Factors that affect mortality in COVID-19 disease

Introduction and Purpose: There has been a high rate of deaths due to the COVID-19 disease, which we have been facing since December 2019. Determining the factors affecting mortality in these patients who are followed up in the intensive care unit is important in terms of reducing the mortality due to the disease. In our study; We aimed to investigate the factors affecting intensive care mortality in COVID-19 patients. Material and Method: Between March 2020 and March 2022, 619 patients with positive COVID-19 RT-PCR test, who were followed up and treated in the Anesthesia Intensive Care Units of Akdeniz University Faculty of Medicine, were included in our study. Patients under the age of 18 years and with negative COVID-19 RT-PCR test were not included in the study even if they had chest computed tomography findings or symptoms. The demographic data of the patients, comorbidities, laboratory parameters, vaccination status, and clinical conditions developed during the intensive care follow-up were analyzed retrospectively, the information of living and deceased patients was compared and the factors affecting intensive care mortality due to COVID-19 disease were analyzed. Results: A high mortality rate of 58.6% was observed in COVID-19 patients admitted to the intensive care unit. Advanced age (60-71; p<0.001), comorbidities (hypertension, arrhythmia, chronic lung diseases, solid organ malignancy, neurological diseases; p<0.001), unvaccinated status (68-82.4%; p<0.001) ) have been shown to be associated with mortality. Moreover; High SOFA (4-5; p<0.001) and APACHE II (9-15; p<0.001) scores during admission to the ICU, lower PaO2/FiO2 ratio and need for invasive mechanical ventilator (23.8%-93%) ,9; p<0.001), development of complicated clinical conditions secondary to COVID-19 (moderate-severe ARDS, MODS, DIC, myocardial infarction, sepsis/septic shock, bleeding, thrombosis/embolism), presence of electrolyte abnormalities, hypoalbuminemia and CRP showed that ferritin, creatinine, procalcitonin values and high N/L, M/L, N/Plt ratio were associated with mortality. Conclusion: This work; It has been shown that intensive care mortality is high in COVID-19 disease, advanced age and comorbidities, vaccination status, high SOFA and APACHE II scores at admission affect intensive care mortality.