Clinical and Laboratory Predictors for ICU Admission among COVID-19 Infected Egyptian Patients, A multi-Center Study

Abstract

Background and study aim: The incremental global spread of the SARS-CoV-2 virus imposes an enormous burden ‎on medical health systems. We focused on determining the predictors for the COVID-‎‎19 patient's course of illness and what level of care will be actually needed at hospital ‎admission‎‎. Patients and Methods: ‎‎‎170 symptomatic COVID-19 Egyptian patients were gleaned from August 2020 to ‎January 2021, were categorized into a group that managed at home or ward admitted ‎and a group that necessitated ICU hospitalization at Tanta University or Kafr El-sheikh ‎University isolation hospitals. Each patient's demographics, clinical, laboratory, and ‎radiological data were gathered and several classification strategies were applied. The ‎variables that predicted the severity of disease and ICU admission were established via ‎logistic regression. The area under the receiver operating characteristic curve was used ‎to assess performance‎‎.‎ Results: The top risk variables predicting ICU admission were blood oxygen saturation ‎‎(P<0.001), serum ferritin (P= 0.023), WHO assessment scale (P= 0.001) and presence ‎of fatigue (P= 0.001) or myalgia (P= 0.028) and with the best accuracy for WHO ‎assessment scale >4 and oxygen saturation ≤90 with an AUC of 0.850 (95% CI [0.795 ‎‎– 0.905]) and 0.800 (95% CI [0.735 – 0.865]), respectively‎. Conclusion: Fatigue, myalgia, oxygen saturation, pulse, respiratory rates, ferritin, and C- reactive ‎protein may prove useful for physicians to distinguish which COVID-19 patients will ‎be required to be managed critically at hospital admission‎‎‎‎‎‎.