Factors influencing death in COVID-19 patients treated in the ICU: a single-centre, cross-sectional study

Background: This single-centre study investigated factors influencing death in corona -virus disease 2019 (COVID-19) patients treated in an intensive care unit (ICU). Methods: Data of 113 consecutive patients with a severe form of COVID-19 infection, who completed their ICU stay in a large COVID-19-dedicated hospital in the Silesian Region of Poland during one year of the pandemic (between 10 March, 2020 and 10 March, 2021), were reviewed. Comprehensive comparison of all available ICU pre-admission, admission and treatment variables was performed. Variables that independently influenced ICU death were identified. Results: ICU mortality in the whole group was 64.6%. Mean age was higher in non -survivors (64.6 +/- 9.5 vs. 60.0 +/- 12.8 years, P = 0.036), but the distribution of sex and body mass index was similar in both groups. Non-survivors had a marginally higher mean Charlson Comorbidity Index (5.9 +/- 3.6 vs. 4.5 +/- 4.1 points, P = 0.063), and significantly higher mean Clinical Frailty Score (4.8 +/- 1.5 vs. 3.9 +/- 1.4 points, P = 0.004), admission APACHE II score (22.9 +/- 7.9 vs. 19.1 +/- 7.8 points, P = 0.017) and SAPS II score (62.1 +/- 18.1 vs. 54.0 +/- 16.7 points, P = 0.023). Factors that independently influenced ICU death were limited to: admission total protein < 50 g L-1 (OR = 11.5, P = 0.002), procalcitonin level > 2.0 ng mL(-1) (OR = 11.3, P = 0.026) and lactate level > 2.0 mmol L-1 (OR = 4.2, P = 0.003) as well as Clinical Frailty Score >= 5 points (OR = 3.1, P = 0.021). Conclusions: The presence of low total protein, frailty and increased procalcitonin and lactate levels at ICU admission are associated with ICU death in patients with severe COVID-19 infection.