The outcomes of severe COVID-19 pneumonia managed with supportive care in Palestine: an experience from a developing country

Introduction: About 14% of COVID-19 patients experience severe symptoms and require hospitalization. Managing these patients could be challenging for limited-resource countries, such as Palestine. This study aimed to evaluate hospitalized severe COVID-19 patients' treatment outcomes managed wit...

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Veröffentlicht in:Journal of infection in developing countries 2021-08, Vol.15 (8), p.1094-1103
Hauptverfasser: El-Hamshari, Yousef, Hamarshi, Majdi, Nazzal, Zaher, Akkawi, Amna, Saleh, Dana, Abdullah, Ibtesam, Najjar, Mohammed, Rabi, Razan, Ruzzeh, Saad
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container_end_page 1103
container_issue 8
container_start_page 1094
container_title Journal of infection in developing countries
container_volume 15
creator El-Hamshari, Yousef
Hamarshi, Majdi
Nazzal, Zaher
Akkawi, Amna
Saleh, Dana
Abdullah, Ibtesam
Najjar, Mohammed
Rabi, Razan
Ruzzeh, Saad
description Introduction: About 14% of COVID-19 patients experience severe symptoms and require hospitalization. Managing these patients could be challenging for limited-resource countries, such as Palestine. This study aimed to evaluate hospitalized severe COVID-19 patients' treatment outcomes managed with supportive care and steroids. Methodology: This was a single-center observational retrospective cohort study that enrolled COVID-19 patients admitted to the “Martyrs medical military complex- COVID Hospital” in Palestine. The managing physicians manually collected data through chart reviews, including patients' characteristics, complications, outcomes, and different management modalities. Continuous and categorical variables between those who were discharged alive and who died were compared using t-test and Chi-squares test, respectively. Results: Overall, 334 patients were included in this study. Median (IQR) age was 62(11) years, 49.1% were males, and 29.6% were ICU status patients. The median (IQR) PaO2/FiO2 ratio was 76 (67), and 67.6% of these patients had moderate to severe acute respiratory distress syndrome, and 4.8% of the patients received invasive mechanical ventilation. Most of the patients (78.7%) had at least one comorbidity, and 18.3% developed at least one complication. The overall mortality was 12.3% (95% CI 8.9-16.2%), and the median (IQR) length of hospital stay was 11 (8) days. Age (aOR 1.05, p = 0.08), smoking (aOR 4.12, p = 0.019), IMV (aOR 27.4, p < 0.001) and PaO2/FiO2 ratio (aOR 1.03, p < 0.001) were found to predict higher mortality. Conclusions: Supportive care for patients with severe COVID-19 pneumonia in a Palestinian hospital with limited resources was associated with in-hospital mortality of 12.3%.
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Managing these patients could be challenging for limited-resource countries, such as Palestine. This study aimed to evaluate hospitalized severe COVID-19 patients' treatment outcomes managed with supportive care and steroids. Methodology: This was a single-center observational retrospective cohort study that enrolled COVID-19 patients admitted to the “Martyrs medical military complex- COVID Hospital” in Palestine. The managing physicians manually collected data through chart reviews, including patients' characteristics, complications, outcomes, and different management modalities. Continuous and categorical variables between those who were discharged alive and who died were compared using t-test and Chi-squares test, respectively. Results: Overall, 334 patients were included in this study. Median (IQR) age was 62(11) years, 49.1% were males, and 29.6% were ICU status patients. The median (IQR) PaO2/FiO2 ratio was 76 (67), and 67.6% of these patients had moderate to severe acute respiratory distress syndrome, and 4.8% of the patients received invasive mechanical ventilation. Most of the patients (78.7%) had at least one comorbidity, and 18.3% developed at least one complication. The overall mortality was 12.3% (95% CI 8.9-16.2%), and the median (IQR) length of hospital stay was 11 (8) days. Age (aOR 1.05, p = 0.08), smoking (aOR 4.12, p = 0.019), IMV (aOR 27.4, p &lt; 0.001) and PaO2/FiO2 ratio (aOR 1.03, p &lt; 0.001) were found to predict higher mortality. 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Managing these patients could be challenging for limited-resource countries, such as Palestine. This study aimed to evaluate hospitalized severe COVID-19 patients' treatment outcomes managed with supportive care and steroids. Methodology: This was a single-center observational retrospective cohort study that enrolled COVID-19 patients admitted to the “Martyrs medical military complex- COVID Hospital” in Palestine. The managing physicians manually collected data through chart reviews, including patients' characteristics, complications, outcomes, and different management modalities. Continuous and categorical variables between those who were discharged alive and who died were compared using t-test and Chi-squares test, respectively. Results: Overall, 334 patients were included in this study. Median (IQR) age was 62(11) years, 49.1% were males, and 29.6% were ICU status patients. The median (IQR) PaO2/FiO2 ratio was 76 (67), and 67.6% of these patients had moderate to severe acute respiratory distress syndrome, and 4.8% of the patients received invasive mechanical ventilation. Most of the patients (78.7%) had at least one comorbidity, and 18.3% developed at least one complication. The overall mortality was 12.3% (95% CI 8.9-16.2%), and the median (IQR) length of hospital stay was 11 (8) days. Age (aOR 1.05, p = 0.08), smoking (aOR 4.12, p = 0.019), IMV (aOR 27.4, p &lt; 0.001) and PaO2/FiO2 ratio (aOR 1.03, p &lt; 0.001) were found to predict higher mortality. 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subjects Coronaviruses
COVID-19
Mortality
Pneumonia
title The outcomes of severe COVID-19 pneumonia managed with supportive care in Palestine: an experience from a developing country
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