Mortality predictors in critically ill patients with severe COVID-19 pneumonia: A multicenter observational study in Colombia

Introduction: Patients on invasive mechanical ventilation (IMV) with COVID-19 have a high mortality. There is a lack of information on the factors associated with mortality in these patients with a hospital stay of less than 48 hours, which reflects the severity of the disease. Objective: To identify the variables associated with mortality in patients admitted to the intensive care unit (ICU) in IMV with severe pneumonia due to COVID-19. Materials and methods: Prospective study conducted from March 1 to July 30, 2021, in nine ICUs in the city of Medellín, Colombia. Adult patients who required IMV upon admission to the ICU, with a hospital stay of less than 48 hours, were included. The following variables were studied: personal history, laboratory tests, complications during the stay, and medical treatment. A multivariate analysis was performed in a Poisson regression model with robust errors. Results: Of the 148 patients admitted to the study, 35.8% died. The risk factors related to mortality in the multivariate analysis were: older than 65 years [RR 2.15 (1.36 - 3.41)], continuing with IMV on day 7 of stay [RR 3.13 (1, 13 – 8.69)], and a history of chronic kidney disease [RR 2.09 (1.2 - 3.64)]. Patients with a C-reactive protein value greater than 10 mg/dL had lower mortality [RR 0.65 (0.44 – 0.95)]. Conclusions: Continuing IMV on day 7, being over 65 years of age, or chronic kidney disease were the risk factors associated with mortality.