Factors associated with mortality of patients with COVID-19 on invasive mechanical ventilation: A retrospective cohort study in a university hospital in Northeastern Brazil

• Published in: Anais da Academia Brasileira de Ciências Vol. 96; no. 3; p. e20231355
• Main Authors: Soares, Thiago Henrique M, Moraes, Nelson Henrique L DE, Soares, Karina P N D, Carvalho, Marizélia M, Holanda, Alessandro S S, Rodrigues, Laryssa Fernanda S, Silva, Maria Eduarda P, Carvalho, Paulo Roberto C
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Academia Brasileira de Ciências 01.01.2024
• Subjects: Adult; Aged; Brazil - epidemiology; Comorbidity; COVID-19; COVID-19 - mortality; critical care outcomes; Female; Hospital Mortality; Hospitals, University; Humans; intensive care unit; Intensive Care Units - statistics & numerical data; Length of Stay - statistics & numerical data; Male; mechanical ventilation; Middle Aged; mortality; MULTIDISCIPLINARY SCIENCES; Respiration, Artificial - statistics & numerical data; Retrospective Studies; Risk Factors; SARS-CoV-2; Brazil; COVID-19; mortality; critical care outcomes; intensive care unit; mechanical ventilation
• ISSN: 0001-3765; 1678-2690; 1678-2690
• DOI: 10.1590/0001-3765202420231355

The aim of this study is to identify the factors associated with mortality in patients with COVID-19 undergoing invasive mechanical ventilation at a university hospital in Northeastern Brazil. This is a retrospective cohort from April to August 2020 through an analysis of medical records, considering the demographic profile, comorbidities, complications, supports, respiratory and laboratory parameters. A total of 65 patients required invasive mechanical ventilation, of which 64.6% died in the ICU. They were older, had more comorbidities, shorter length of stay in the intensive care unit, received more support such as palliative care and two vasopressors simultaneously, showed lower levels of pH, hemoglobin and calcium, and higher levels of bicarbonate, lactate, prothrombin time, international normalized ratio, troponin and ferritin at the start of invasive mechanical ventilation. Furthermore, the time course of pH, arterial oxygen partial pressure to fractional inspired oxygen ratio, arterial carbon dioxide partial pressure, lactate, hemoglobin, platelets, lymphocytes, neutrophil-to-lymphocyte ratio, coagulation parameters, calcium, urea, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, ferritin, static compliance, airway resistance, tidal volume, and noradrenaline doses showed association with mortality. There was a high mortality rate in invasively mechanically ventilated COVID-19 patients, with some associated factors identified at the start of invasive mechanical ventilation and others identified over time.