Impact of common comorbidities on antimicrobial consumption and mortality amongst critically ill COVID-19 patients: A retrospective two center study in Saudi Arabia
AlQadheeb et al.,
Impact of common comorbidities on antimicrobial consumption and mortality amongst critically ill COVID-19..,
Clinical Infection in Practice, doi:10.1016/j.clinpr.2023.100229
Retrospective 848 ICU patients in Saudi Arabia, showing lower mortality with HCQ in unadjusted results.
risk of death, 34.8% lower, RR 0.65, p < 0.001, treatment 37 of 92 (40.2%), control 466 of 756 (61.6%), NNT 4.7.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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AlQadheeb et al., 10 May 2023, retrospective, Saudi Arabia, peer-reviewed, mean age 55.8, 9 authors, study period March 2020 - August 2021.
Contact:
nada.qadheeb@kfsh.med.sa, nalqadheeb@moh.gov.sa.
Abstract: Clinical Infection in Practice 19 (2023) 100229
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Clinical Infection in Practice
journal homepage: www.sciencedirect.com/journal/clinical-infection-in-practice
Practical clinical reviews
Impact of common comorbidities on antimicrobial consumption and
mortality amongst critically ill COVID-19 patients: A retrospective two
center study in Saudi Arabia
Nada AlQadheeb a, *, Hanine AlMubayedh b, Sarah AlBadrani b, Abdul Salam c,
Mukhtar AlOmar a, Ahmed AlAswad d, Mohammed AlMualim d, Zahra AlQamariat e,
Rasheed AlHubail f
a
Pharmacy Department, King Fahad Specialist Hospital, Eastern Province, Saudi Arabia
College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Eastern Province, Saudi Arabia
c
Department of Biostatistics and Epidemiology, King Fahad Specialist Hospital, Eastern Province, Saudi Arabia
d
Critical Care Department, Qatif Central Hospital, Eastern Province, Saudi Arabia
e
Pharmacy Department, Dammam Medical Complex, Eastern Province, Saudi Arabia
f
Critical Care Department, Dammam Medical Complex, Eastern Province, Saudi Arabia
b
A R T I C L E I N F O
A B S T R A C T
Keywords:
Mortality
COVID-19
Comorbidities
Intensive care unit
Saudi Arabia
Objectives: To determine the association between common comorbidities, ICU mortality and antimicrobial con
sumption among critically ill COVID 19 patients in Saudi Arabia.
Methods: A retrospective observational study of patients admitted to the ICU from March 1st, 2020, through
August 31st, 2021. We excluded patients who stayed <24 h in the ICU and with no confirmed COVID-19 PCR
testing.
Results: Of the 976 screened ICU patients, 848 were included. While there was no difference in mortality between
patients with and without comorbidities, those with at least one comorbidity had a higher severity of illness (p =
0.013). Compared to survivors, non-survivors were more likely to require mechanical ventilation and vasopressor
support (P < 0.001). Almost all patients received at least one antimicrobial therapy. Predictors independently
associated with ICU mortality were: older age (adjusted odds ratio [AOR], 1.03; 95% confidence interval [CI],
1.01–1.04), vancomycin use (AOR, 2.69; 95% [CI], 1.65–4.37), linezolid use (AOR, 2.65; 95% [CI], 1.65–4.04),
sepsis or septic shock (AOR, 6.39; 95% [CI], 3.68–11.08), Acute Kidney Injury (AKI) (AOR, 2.51; 95% [CI],
1.61–3.92) and Acute Respiratory Distress Syndrome (ARDS) (AOR, 2.03; 95% [CI], 1.61–3.92).
Conclusion: Older age, vancomycin and linezolid use, sepsis/septic shock, AKI, and ARDS were negative prog
nostic factors in critically ill COVID-19 patients. More studies are needed to evaluate the outcomes of survived
critically ill patients in relation to their vaccination status.
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