Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study.
| Title: | Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study. |
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| Authors: | Elhadi M; Faculty of Medicine University of Tripoli, Tripoli, Libya.; Alsoufi A; Faculty of Medicine University of Tripoli, Tripoli, Libya.; Abusalama A; Almwasfat Isolation Hospital, Tripoli, Libya.; Alkaseek A; Gharyan Hospital, Gharyan, Libya.; Abdeewi S; Sebha Medical Center, Sebha, Libya.; Yahya M; Almarj Teaching Hospital, Almarj, Libya.; Mohammed A; Almarj Teaching Hospital, Almarj, Libya.; Abdelkabir M; Sebha Medical Center, Sebha, Libya.; Huwaysh M; Alshahid Attia Alkasah General Hospital, Alkufra, Libya.; Amkhatirah E; Almarj Teaching Hospital, Almarj, Libya.; Alshorbaji K; Misurata Medical Center, Misurata, Libya.; Khel S; Soq Altholatha Isolation Center, Tripoli, Libya.; Gamra M; Emeitiga Military Hospital, Tripoli, Libya.; Alhadi A; Sorman Isolation Center, Sorman, Libya.; Faculty of Medicine, University of Zawia, Az Zawiyah, Libya.; Abubaker T; Benghazi Medical Center, Benghazi, Libya.; Anaiba M; Misurata Medical Center, Misurata, Libya.; Elmugassabi M; Misurata Medical Center, Misurata, Libya.; Binnawara M; Tripoli Central Hospital, Tripoli, Libya.; Khaled A; Faculty of Medicine University of Tripoli, Tripoli, Libya.; Zaid A; Faculty of Medicine University of Tripoli, Tripoli, Libya.; Msherghi A; Faculty of Medicine University of Tripoli, Tripoli, Libya. |
| Source: | PloS one [PLoS One] 2021 Apr 30; Vol. 16 (4), pp. e0251085. Date of Electronic Publication: 2021 Apr 30 (Print Publication: 2021). |
| Publication Type: | Journal Article; Multicenter Study; Observational Study |
| Language: | English |
| Journal Info: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: San Francisco, CA : Public Library of Science |
| MeSH Terms: | COVID-19/*epidemiology ; Critical Illness/*epidemiology; COVID-19/blood ; COVID-19/mortality ; COVID-19/therapy ; Critical Illness/mortality ; Critical Illness/therapy ; Libya/epidemiology ; SARS-CoV-2/isolation & purification ; Aged ; Critical Care ; Female ; Hospital Mortality ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Survival Analysis |
| Abstract: | Background: The coronavirus disease (COVID-19) pandemic has severely affected African countries, specifically the countries, such as Libya, that are in constant conflict. Clinical and laboratory information, including mortality and associated risk factors in relation to hospital settings and available resources, about critically ill patients with COVID-19 in Africa is not available. This study aimed to determine the mortality and morbidity of COVID-19 patients in intensive care units (ICU) following 60 days after ICU admission, and explore the factors that influence in-ICU mortality rate.; Methods: This is a multicenter prospective observational study among COVID-19 critical care patients in 11 ICUs in Libya from May 29th to December 30th 2020. Basic demographic data, clinical characteristics, laboratory values, admission Sequential Organ Failure Assessment (SOFA) score, quick SOFA, and clinical management were analyzed.; Result: We included 465 consecutive COVID-19 critically ill patients. The majority (67.1%) of the patients were older than 60 years, with a median (IQR) age of 69 (56.5-75); 240 (51.6%) were male. At 60 days of follow-up, 184 (39.6%) were discharged alive, while 281 (60.4%) died in the intensive care unit. The median (IQR) ICU length of stay was 7 days (4-10) and non-survivors had significantly shorter stay, 6 (3-10) days. The body mass index was 27.9 (24.1-31.6) kg/m2. At admission to the intensive care unit, quick SOFA median (IQR) score was 1 (1-2), whereas total SOFA score was 6 (4-7). In univariate analysis, the following parameters were significantly associated with increased/decreased hazard of mortality: increased age, BMI, white cell count, neutrophils, procalcitonin, cardiac troponin, C-reactive protein, ferritin, fibrinogen, prothrombin, and d-dimer levels were associated with higher risk of mortality. Decreased lymphocytes, and platelet count were associated with higher risk of mortality. Quick SOFA and total SOFA scores increase, emergency intubation, inotrope use, stress myocardiopathy, acute kidney injury, arrythmia, and seizure were associated with higher mortality.; Conclusion: Our study reported the highest mortality rate (60.4%) among critically ill patients with COVID-19 60 days post-ICU admission. Several factors were found to be predictive of mortality, which may help to identify patients at risk of mortality during the ongoing COVID-19 pandemic. |
| Competing Interests: | The authors have declared that no competing interests exist. |
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| Entry Date(s): | Date Created: 20210430 Date Completed: 20210510 Latest Revision: 20231102 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC8087095 |
| DOI: | 10.1371/journal.pone.0251085 |
| PMID: | 33930079 |
| Database: | MEDLINE |
Journal Article; Multicenter Study; Observational Study