Clinical characteristics and mortality risk among critically ill patients with COVID-19 owing to the B.1.617.2 (Delta) variant in Vietnam: A retrospective observational study

• Published in: PloS one Vol. 18; no. 1; p. e0279713
• Main Authors: Do, Thanh Van, Manabe, Toshie, Vu, Giap Van, Nong, Vuong Minh, Fujikura, Yuji, Phan, Dung, Pham, Thach The, Do, Cuong Duy, Doan, Tra Thu, Nguyen, Nguyen Trung, Nguyen, Thai Quoc, Dong, Thanh Van, Luong, Chinh Quoc, Manabe, Hiroki, Kambayashi, Dan, Hoang, Anh Viet, Vu, Nhan Van, Trinh, Giang Kim, Do, Son Ngoc, Kamiya, Takeshi, Ohara, Hirotaka, Nguyen, Chi Van, Dang, Tuan Quoc, Kudo, Koichiro, Dao, Co Xuan
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.01.2023; Public Library of Science (PLoS)
• Subjects: Antiviral drugs; Bacterial diseases; Biology and life sciences; Blood culture; Coronaviruses; COVID-19; COVID-19 vaccines; Critical Illness; Critically ill; Diabetes mellitus; Disease transmission; Emergency medical care; Ethics; Fatalities; Health risks; Hospitalization; Hospitals; Humans; Infections; Intensive care; Laboratories; Medicine and Health Sciences; Mortality; Mortality risk; Observational studies; Oxygen; Oxygen content; Pandemics; Patient outcomes; Patients; People and Places; Physical Sciences; Respiratory distress syndrome; Respiratory Distress Syndrome - therapy; Retrospective Studies; Risk analysis; Risk factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Survival; Vaccines; Vietnam - epidemiology; Viral diseases; Vietnam; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0279713

SARS-CoV-2 Delta variant caused a large number of COVID-19 cases in many countries, including Vietnam. Understanding mortality risk factors is crucial for the clinical management of severe COVID-19. We conducted a retrospective study at an intensive care center in Ho Chi Minh City that urgently built by Bach Mai Hospital during the COVID-19 outbreak in Vietnam, when the Delta variant predominated. Participants were laboratory-confirmed patients with SARS-CoV-2 infection, admitted in August 2021. Data on patients' demographic and clinical characteristics, radiographic and laboratory findings, treatment, and clinical time course were compared between survivors and non-survivors. Risk factors to mortality were assessed using logistic regression. Among 504 eligible COVID-19 patients, case fatality was 52.2%. Unvaccinated patients accounted for 61.2% of non-survivors and 43.6% of survivors (p < 0.001). The time from onset to hospital admission was 8 days in non-survivors and 7 days in survivors (p = 0.004). Among non-survivors, 90.2% developed acute respiratory distress syndrome (ARDS). Oxygen therapy was administered for all patients, but antiviral agent was given to 51.7% of non-survivors. 54.2% of non-survivors tested positive for the bacterial infection using blood culture. The risk factors for mortality were diabetes mellitus, respiration rate, oxygen saturation, vaccination status, time from onset to admission, and older age. Critical patients with COVID-19 owing to the Delta variant in Vietnam had delayed hospital admission, leading to ARDS and death. Early availability of vaccines and preventing bacterial infections are crucial for reducing mortality of COVID-19, especially in low- and middle-income countries.