Mortality risk factors for COVID-19 patients in the region of Mahdia (Tunisia)

Introduction: Timely identification of COVID-19 patients at high risk of mortality is crucial to improve patient management and resource allocation in hospitals. Objectives: The aim of this study was to identify mortality risk factors at the COVID-19 Intensive Care Unit (ICU) in the region of Mahdia Methods: We conducted a prospective study including patients with severe COVID-19 infection admitted to the ICU of The University Hospital Tahar Sfar Mahdia. The survey was carried out between September 2020 and February 2021. We used “The RAPID CORE CASE REPORT FORM” developed by the World Health Organization. Results: We analyzed the records of 117 patients (59.8% were males). Mean age was 61.4 ± 12.2 years. Common symptoms were shortness of breath (82.6%), cough (71.1%) and fever (69.3%). The median length of stay in the unit was 18.3 days (IQR: 2-66). About 48.7% of patients had invasive ventilation, 30.3% required vasopressors intake and 51.4% required prone position. The overall mortality rate was 46.2%. Longer stay in the hospital (> 14 days) and longer intubation duration (≥ 7 days) were associated with a higher risk of mortality (61.8% vs 32.3%;p < 0.001 and 77.6% vs 20.6%;p < 0.001 respectively). Mortality was also related to acute respiratory distress syndrome (66.7% vs 13%;p < 0.001) and nosocomial infection (80.8%vs 17%;p < 0.01). Multivariable logistic regression analysis showed increasing odds of mortality with nosocomial infection (OR, 12.41 [95% CI, 3.3-46.57], respiratory distress syndrome (OR 7.52 [95% CI. 1.71-32,95]) and inotropes or vasopressors intake (OR 7.39 [95% CI, 1.57-34.69]). Higher oxygen saturation on admission was found to be a protective factor against mortality (OR 0.91 [95% CI, 0.85-0.97]). Conclusion: Interventions that prevent these risk factors are needed to improve the prognosis of Covid-19 patients.