Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains today a global health pandemic. Those with severe infection are at risk of rapid clinical deterioration; as a result, intensive care unit (ICU) admission is not uncommon in such patients. A number of determinants have been identified as predictors of poor prognosis and in-hospital mortality, ranging from demographic characteristics, laboratory and/or radiological findings. Aim: To identify determinants of in-hospital mortality and examine the accuracy of seven early warning scores in predicting in-hospital mortality. Methods: This is a retrospective study conducted in Kuwait from July 2020 to March 2021, and participants were adult patients with a positive test on the real-time polymerase chain reaction (RT-PCR) for SARS-CoV-2 and who met the criteria for ICU admission. Data collected included: demographics, clinical status on hospital arrival, laboratory test results, and ICU course. Furthermore, we calculated seven early warning scores for each of our patients. Results: A total of 133 patients were admitted to our COVID-19 ICU with a median age of 59 years. Arrival to ICU on mechanical ventilation (MV), developing in-hospital complications, having chronic kidney disease (CKD), having a high white blood count (WBC), lactate dehydrogenase (LDH), lactate, or urea levels were found to be significant predictors of in-hospital mortality. Furthermore, the 4C mortality score for COVID-19, VACO index for COVID-19 mortality, and the PRIEST COVID-19 clinical severity score proved to be the most superior in predicting in-hospital mortality. Conclusion: Identifying high-risk patients and those with a poor prognosis allows for efficient triaging and the delivery of high-standard care while minimizing the strain on the healthcare system.
【저자키워드】 COVID-19, Critical care, ICU, SARS-CoV- 2, prognostic scores, 【초록키워드】 SARS-CoV-2, Severe infection, pandemic, Mortality, intensive care, hospital, LDH, risk, Chronic kidney disease, RT-PCR, lactate dehydrogenase, Laboratory, clinical status, Retrospective study, Health, Accuracy, Patient, ICU admission, Kuwait, WBC, predictor, Admission, Care, patients, in-hospital mortality, Blood, Early warning score, Lactate, COVID-19 mortality, CKD, Healthcare system, criteria, demographics, demographic characteristics, urea, determinant, median age, poor prognosis, clinical severity score, participant, Positive test, identifying, in-hospital complications, high-risk patient, radiological, polymerase chain, Seven, Course, identify, collected, conducted, calculated, on mechanical ventilation, 【제목키워드】 Triage, allocation, AID, Factor,