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• Clinical characteristics and predictors of mortality among patients with severe COVID-19 admitted to an Intensive Care Unit in Lagos, Nigeria

  Akinsanya Daniel Olusegun-Joseph, Emmanuel Y Nkanor, Bolanle O. Okunowo, Olayinka Oladunjoye, Adeyemi S. Johnson, Kofo Ogunyankin

  Introduction:
  Coronavirus disease 2019 (COVID-19) remains an important cause of severe illness and mortality worldwide. Patients requiring intensive care frequently have underlying comorbidities and multiple organ dysfunction, which adversely influence clinical outcomes. This study evaluated the clinical characteristics, laboratory findings, and predictors of mortality among patients with severe COVID-19 admitted to an intensive care unit (ICU) in Lagos, Nigeria.

  Methods:
  This retrospective descriptive study reviewed the medical records of adult patients with confirmed COVID-19 admitted into the ICU of First Cardiology Consultants Hospital, Lagos. Demographic characteristics, clinical features, comorbidities, laboratory parameters, and treatment outcomes were extracted and analysed using SPSS version 25. Factors associated with mortality were assessed using appropriate statistical tests and multivariable logistic regression. Statistical significance was set at p <0.05.

  Results:
  Thirty-five patients were included, comprising 28 (80.0%) males and 7 (20.0%) females, with a mean age of 58.4 ± 13.5 years. Hypertension (60.0%) and diabetes mellitus (48.6%) were the commonest comorbidities. Overall mortality was 14.3%. Non-survivors were significantly more likely to have tachycardia, hypertension, hypoxaemia, renal dysfunction, hepatic dysfunction, elevated C-reactive protein, elevated D-dimer, and impaired renal function. Multivariable analysis identified tachycardia as an independent predictor of mortality (p=0.031).

  Conclusion:
  Severe COVID-19 requiring intensive care was associated with a high burden of comorbidities and organ dysfunction. Tachycardia emerged as an independent predictor of mortality, while hypoxaemia, hypertension, renal dysfunction, and hepatic dysfunction were significantly associated with poor outcomes. Early identification and aggressive management of these high-risk features may improve survival among critically ill patients with COVID-19.

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