Comparison of clinical characteristics and outcomes between COVID-19 survivors and non-survivors: a retrospective observational study

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Background: To compare the clinical characteristics of COVID-19 survivors and non-survivors who were transferred from general wards to the critical care units in four tertiary hospitals of Nepal. Methods: This study utilized electronic data from the National Intensive Care Unit (ICU) registry managed by the Nepal Intensive Care Research Foundation (NICRF). A retrospective observational study was conducted among 78 eligible COVID-19 patients admitted to the intensive care units of four different hospitals between 2020 and 2022. The Mann-Whitney U test was used to compare each continuous variable between the survivors and non survivors, while Pearson's chi-squared test was used to examine the association between each categorical variable and outcome. Results: Among 78 cases of COVID-19 studied, 29 (37.1%) had died, and 49 (62.8%) had recovered. The median age of the patient was 57.5 years, with a higher percentage of males (66.6%). Hypertension (41%) and diabetes (26.9%) were common comorbidities, whereas pneumonia (41%) and acute respiratory distress syndrome (19.2%) were common complications. Most patients required oxygen therapy (96.2%). Corticosteroids (76.9%) and anticoagulants (83.3%) were commonly administered medications. Median of mean arterial pressure was 85 mm Hg [IQR- 79.2-99.5] in non-survivors and 93.3 mm Hg [IQR- 86.6-102.6] in survivors which was significantly different between the two groups (p = 0.04). Nine of the patients had cardiac dysfunction on ICU admission, of which none survived (p = 0.001). Out of ten patients requiring inotropes or vasopressors, only two survived (p = 0.001). Conclusions: Non-survivor COVID patients had lower mean arterial pressure on admission to intensive care units. A higher proportion of patients with cardiac dysfunction and requiring inotropes or vasopressors could not survive.

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