Comparison of clinical characteristics and outcomes between COVID-19 survivors and non-survivors: a retrospective observational study

Background To compare the clinical characteristics of COVID-19 survivors and non-survivors who were transferred from general wards to the critical care units in four tertiary hospitals of Nepal. Methods This study utilized electronic data from the National Intensive Care Unit (ICU) registry managed by the Nepal Intensive Care Research Foundation (NICRF). A retrospective observational study was conducted among 78 eligible COVID-19 patients admitted to the intensive care units of four different hospitals between 2020 and 2022. The Mann-Whitney U test was used to compare each continuous variable between the survivors and non survivors, while Pearson's chi-squared test was used to examine the association between each categorical variable and outcome. Results Among 78 cases of COVID-19 studied, 29 (37.1%) had died, and 49 (62.8%) had recovered. The median age of the patient was 57.5 years, with a higher percentage of males (66.6%). Hypertension (41%) and diabetes (26.9%) were common comorbidities, whereas pneumonia (41%) and acute respiratory distress syndrome (19.2%) were common complications. Most patients required oxygen therapy (96.2%). Corticosteroids (76.9%) and anticoagulants (83.3%) were commonly administered medications. Median of mean arterial pressure was 85 mm Hg [ IQR- 79.2 - 99.5] in non-survivors and 93.3 mm Hg [IQR- 86.6 - 102.6 ] in survivors which was significantly different between the two groups (p=0.04). Nine of the patients had cardiac dysfunction on ICU admission, of which none survived (p=0.001). Out of ten patients requiring inotropes or vasopressors, only two survived (p=0.001). Conclusions Non-survivor COVID patients had lower mean arterial pressure on admission to intensive care units. A higher proportion of patients with cardiac dysfunction and requiring inotropes or vasopressors could not survive.