Background: Coronavirus disease 2019 (COVID-19) has resulted in considerable morbidity and mortality worldwide since December 2019. This study highlights the significant burden of the COVID-19 outbreak, particularly in patients’ health and the healthcare system. This study's clinical implication provides insight into the significant death indicators among COVID-19 patients in Saudi Arabia. Exploring these indicators will help physicians triage patients, identify critically ill patients, and prioritize ICU admissions by identifying high-risk medical and clinical indicators.
Methods: A multi-center retrospective study conducted among all COVID-19 mortality cases, admitted to 15 of Armed forces hospitals across Saudi Arabia regions during March – July 2020. Demographic data, clinical presentation, laboratory investigations, and complications of COVID-19 mortality cases were collected and analyzed. According to the WHO, death due to COVID-19 was classified as a direct and indirect cause of death.
Results: A total of 224 COVID-19 mortality cases were included in the analysis. The mean age was 69.6614.68 years, and 142(63.4%) of the cases were male. 30% of overall COVID-19 mortalities occurred in the first 24 hours of hospital admission, while 50% of the mortalities occurred on day 10. There was a highly significant difference in the survival time (days) between cases admitted to the Intensive care unit (ICU) and general ward (p-values <.001), as well as a significant difference in the survival time (days) between the direct and indirect cause of death from COVID-19 cases (p-values 0.012). The most prevalent comorbidities were diabetes mellitus (DM) occurred in 165(73.7%), and hypertension (HTN) in 156(69.6%). Logistic regression for risk factors in all mortality cases revealed that direct mortality cases from COVID-19 are more likely to develop acute respiratory distress syndrome and acute kidney injury [OR 1.75 (CI 0.89-3.43); p=.102], [OR 1.01 (CI 0.54-1.90); p=.960].
Conclusions: The prevalence of underlying diseases DM and HTN is high among COVID‐19 mortality cases in Saudi Arabia. Multiple organ dysfunction can be observed, the most common organ damage, lungs, heart, followed by the kidney. The rising of serum ferritin, Procalcitonin, CRP, and D-dimer levels can be used as indicators of disease progression.
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