Risk factors associated with mortality in critically ill patients with SARS-CoV-2 pneumonia in a tertiary hospital in Ecuador

Objectives: SARS-CoV-2 pneumonia in critically ill patients is characterized by a high mortality rate. Numerous risk factors have been identified for this condition. The objective of this study was to determine the risk factors for mortality in critically ill patients with SARS-CoV-2 pneumonia receiving invasive mechanical ventilation. Methods: This was an observational and retrospective study of patients who were in the intensive care unit of a third-level hospital between March 2020 and September 2021. Adults with confirmed SARS-CoV-2 infection and who were in the unit for more than 48 hours were included. Demographic, clinical, laboratory, and mechanical ventilation data were collected. All patients received protocolized treatments. Univariate and multivariate analyses were performed, with a p value of < 0.05, and the R statistical tool was used. Results: Of 1024 patients, 203 were analyzed. In the univariate analysis, the age, weight, hypertension status, Simplified Acute Physiology Score III, Charlson Comorbidity Index score, neutrophil/lymphocyte ratio and acute respiratory distress syndrome status significantly differed between the living and deceased patients groups. In the multivariate analysis, the Charlson Comorbidity Index score (OR 1.36, 95% CI 1.12-1.68, p=0.002), acute respiratory distress syndrome (OR 4.16, 95% CI 1.24-16.04, p=0.02), and neutrophil/lymphocyte ratio (OR 1.040, 95% CI 1.00-1.07, p= 0.02) remained statistically significant. The mortality rate in the unit was 58.1%. Conclusions: The Charlson Comorbidity Index score, neutrophil/lymphocyte ratio and acute respiratory distress syndrome status were associated with increased mortality.