European Journal of Biomedical and Pharmaceutical Sciences

DETERMINANT FACTORS FOR A LONG STAY IN INTENSIVE CARE FOR COVID-19 PATIENTS

H. Bennani*, M. Ababou, W. Atmani, H. Bakkali, N. Doghmi, H. Balkhi

ABSTRACT

Introduction: The COVID-19 pandemic has put unprecedented pressure on healthcare systems, with a rising demand for hospital and intensive care unit (ICU) services worldwide. As the pandemic intensifies, a key priority for many countries has become determining the healthcare resource needs, including beds, staff, and equipment. Forecasting future demand requires an estimation of the duration for which COVID-19 patients need different levels of hospital care, particularly in intensive care and ICUs. Objective: The objective of this work was to identify the determinant factors of a long stay (LOS) in intensive care for patients with severe COVID-19 pneumonia. Methods: This was a six-month case-control study conducted at the HMMV COVID-19 intensive care unit from August 2020 to February 2021. The study included patients hospitalized for COVID-19 pneumonia, with a diagnosis confirmed by a positive PCR test or based on clinical, biological, and radiological findings. Data were collected from the medical records of patients admitted to the ICU, including age, sex, BMI, and comorbidities such as diabetes, hypertension (HBP), cardiovascular diseases, asthma, COPD, hypothyroidism, and neoplastic pathologies. The degree of lung involvement from a CT scan and the use of mechanical ventilation (MV) were also recorded. The primary outcome was the length of stay in intensive care, defined as the time from admission to discharge (either by transfer, death, or survival). A patient was considered to have a "long stay" if they remained in the ICU for more than 5 days. Results: During the study period, 300 patients who tested positive for SARS-CoV-2 were admitted to the ICU. The average age of the patients was 67 ± 11 years, and 217 were male (72.3%). The majority of patients had medical comorbidities, with the most common being diabetes (35.7%), hypertension (31.8%), and obesity (29.7%). The length of stay ranged from 2 to 30 days, with a mean duration of 7.12 days and a median of 6 days. Using a multivariate logistic regression analysis, the adjusted odds ratios (ORa) showed a significant association between a long of stay (LoS) and the following factors:
 Mechanical ventilation (MV): ORa 3.38 (95% CI 1.67–6.83).
 Obesity: ORa 6.25 (95% CI 15.3–2.56).
 Neoplastic pathologies : ORa 4 (95% CI 13.69–1.14).
 Diabetes: ORa 2.55 (95% CI 1.34–4.85).
Other factors, including age, sex, and radiological findings, did not show a significant association with a prolonged stay. Conclusion: In this study, it appears highly probable that mechanical ventilation, obesity, and neoplastic pathologies are the factors most strongly associated with a long stay in intensive care for patients with COVID-19 pneumonia. In the absence of local data, identifying these factors can be used to model bed demand for planning ICU and intensive care services, thereby optimizing the management of resources and critical care capacity.

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