What factors put critically ill patients more at risk of dying from COVID-19?

Bottom Line:

Multiple factors lead to a higher risk of death in critically ill patients with COVID-19, including older age, higher body mass index (BMI), active cancer, organ dysfunction, and being admitted to a hospital with fewer ICU beds.

Reference:

Gupta, S. et al. Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US. JAMA Internal Medicine (2020). https://doi.org/10.1001/jamainternmed.2020.3596

Date Published:

15 July 2020

Synopsis:

More people have died in the United States from COVID-19 than in any other country in the world, however, there has been a lack of data from the US regarding characteristics and outcomes of patients with critical illness. The main purpose of this study was therefore to assess what factors have been associated with the deaths of critically ill patients across the US. Adult patients were included in the study if they were admitted to an ICU with COVID-19-related illness between March 4 and April 4, and researchers followed these patients until their discharge or death. 2215 patients from 65 hospitals in the US were followed for the purpose of this study. 35% of these patients died within 28 days of being admitted to the ICU. Patient factors associated with a higher risk of death were older age, male sex, higher body mass index, coronary artery disease, and active cancer. Although older age was a risk factor for death, at least 15% of patients died in every age group, including under 40 years of age. Illness factors associated with a higher risk of death were hypoxemia (a low level of oxygen in the blood), liver dysfunction and kidney dysfunction at the time of admission to the ICU. Hospitals with fewer ICU beds also led to a higher risk of death in patients admitted. When researchers examined racial differences, they found that black patients were more likely to be hospitalized for their illness, however, were not found to have a higher risk of death.

Summary by: Caroline Gregory