Patients with COVID-19: Predictors of Hospitalization in the Intensive Care Unit

Background: The COVID-19 pandemic has highlighted the critical need to identify patients at high risk of severe outcomes, including intensive care unit (ICU) admission. Objectives: The aim of this study was to determine the predictors of hospitalization in the intensive care unit (ICU) in patients with COVID-19. Method: This research is a retrospective descriptive-analytical study and the data were obtained from the medical records of 386 patients with confirmed COVID-19 at Razi hospital in Rasht, North of Iran. Data were collected using a researcher-made questionnaire, including four sections of individual, clinical, laboratory, and respiratory factors of the patients. Data was analyzed using multiple logistic regression model in SPSS version 16. Results: The rate of ICU hospitalization based on symptoms of shortness of breath (P<0.001), fatigue (P=0.015), loss of sense of smell (P=0.024), and other symptoms (P<0.001), taking anti-asthma and pulmonary drugs (P=0.006), and a history of smoking (P=0.002) was statistically significant. The mean and median scores of respiration rate (RR) (P<0.001), peripheral blood oxygen saturation (P<0.001), arterial oxygen relative pressure ratio to inspiratory oxygen fraction (P<0.001), blood pH (P=0.015), arterial blood oxygen pressure (P<0.001), and arterial blood oxygen saturation (P<0.001) showed a significant difference between the two groups of patients with and without ICU hospitalization. In the final logistic regression model, fever (odds ratio (OR)=4, P=0.005), a history of smoking (OR =6.5, P=0.002), RR (OR=1.2, P=0.004), and arterial oxygen relative pressure ratio to inspiratory oxygen fraction (OR=0.974, P<0.001) were the most important predictors related to ICU hospitalization in patients with COVID-19. Conclusion: The study results showed that identifying factors such as fever, a history of smoking, RR, and arterial oxygen relative pressure ratio to inspiratory oxygen fraction can help formulate prevention, treatment, and support plans for patients with COVID-19.