Early vs late ICU admission in patients with COVID-19 pneumonia

Authors

  • Miguel Alejandro Pinzón Department of Infectious Diseases, Clínica Medellín, Grupo Quirónsalud, Medellín, Colombia
  • Santiago Ortiz Faculty of Engineering, Universidad de San Buenaventura, Cali, Colombia https://orcid.org/0000-0002-9121-3807
  • Henry Laniado Department of Mathematics, Universidad del Cauca, Popayán, Colombia
  • Nelson Javier Fonseca-Ruiz Department of Intensive Care, Nueva Clínica Sagrado Corazón, Medellín, Colombia https://orcid.org/0000-0003-0133-6916
  • Juan Felipe Betancur Department of Internal Medicine, Clínica Medellín, Grupo Quirónsalud, Medellín, Colombia
  • Héctor Holguín Department of Pharmacology, Clínica Medellín, Grupo Quirónsalud, Medellín, Colombia
  • Pablo Montoya Department of Internal Medicine, Clínica Medellín, Grupo Quirónsalud, Medellín, Colombia
  • Bernardo Javier Muñoz Department of Pneumology, Clínica Medellín, Grupo Quirónsalud, Medellín, Colombia
  • Beatriz Ramírez Department of Epidemiology, Clínica Medellín, Grupo Quirónsalud, Medellín, Colombia
  • Carolina Arias Arias Department of Epidemiology, Universidad CES, Medellín, Colombia
  • Isabel Potes Department of Epidemiology, Clínica Medellín, Grupo Quirónsalud, Medellín, Colombia
  • Luz Maribel Toro Department of Epidemiological Surveillance, Nueva Clínica Sagrado Corazón, Medellín, Colombia https://orcid.org/0000-0003-0360-4152
  • Julian Quiceno Department of Internal Medicine, Clínica Medellín, Grupo Quirónsalud, Medellín, Colombia

DOI:

https://doi.org/10.3855/jidc.18286

Keywords:

COVID-19, pneumonia, intensive care unit admission, robust proportional hazard, recovery time

Abstract

Introduction: The type of admission to the Intensive Care Unit (ICU) influences the prognosis of patients with severe pneumonia and, in the case of patients with COVID-19 pneumonia, this is still unexplored. The objective of this study was to determine the differences between early and late ICU admission.

Methodology: A retrospective cohort study of patients with COVID-19 pneumonia at two high-complexity hospitals in Colombia. Early ICU admission (EICUA) was defined as direct admission from the emergency department or within the first 24 hours of admission. Late ICU admission (LICUA) was defined as admission from the hospitalization service after 24 hours of arrival. A robust Cox regression was performed for the variable recovery time, to determine the impact of the ICU admission type in the hazard rate.

Results: 68.2% were EICUA patients and 31.8% were LICUA patients. Recovery and duration of hospital stay were significantly lower in EICUA than in LICUA (9 vs 15 days, p = 0.0001, and 10 vs 15.5 days, p < 0.0001, respectively). However, the duration of ICU stay (7 vs 9 days, p = 0.131) and the invasive mechanical ventilation requirement (48.9% vs 54.9%, p = 0.374) were not statistically significant. The 30-day follow-up showed no difference between the EICUA and LICUA (alive 97% vs 94.6%, p = 0.705).

Conclusions: Mortality between EICUA and LICUA patients with COVID-19 pneumonia showed no statistically significant differences. However, the recovery time, the probability intensity of instant recovery, and the duration of hospital stay were better in EICUA than in LICUA. Neither EICUA nor LICUA affects the final status (death) of patients.

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Published

2024-09-30

How to Cite

1.
Pinzón MA, Ortiz S, Laniado H, Fonseca-Ruiz NJ, Betancur JF, Holguín H, Montoya P, Muñoz BJ, Ramírez B, Arias Arias C, Potes I, Toro LM, Quiceno J (2024) Early vs late ICU admission in patients with COVID-19 pneumonia. J Infect Dev Ctries 18:1338–1346. doi: 10.3855/jidc.18286

Issue

Vol. 18 No. 09: September 2024

Section

Coronavirus Pandemic

License

Copyright (c) 2024 Miguel Alejandro Pinzón, Santiago Ortiz, Henry Laniado, Nelson Fonseca, Juan Felipe Betancur, Héctor Holguín, Pablo Montoya, Bernardo Javier Muñoz, Beatriz Ramírez, Carolina Arias Arias, Isabel Potes, Luz Maribel Toro, Julian Quiceno

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