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 wi...

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Main Authors: Yousef El-Hamshari, Majdi Hamarshi, Zaher Nazzal, Amna Akkawi, Dana Saleh, Ibtesam Abdullah, Mohammed Najjar, Razan Rabi, Saad Ruzzeh
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2021-08-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/14709
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author Yousef El-Hamshari
Majdi Hamarshi
Zaher Nazzal
Amna Akkawi
Dana Saleh
Ibtesam Abdullah
Mohammed Najjar
Razan Rabi
Saad Ruzzeh
author_facet Yousef El-Hamshari
Majdi Hamarshi
Zaher Nazzal
Amna Akkawi
Dana Saleh
Ibtesam Abdullah
Mohammed Najjar
Razan Rabi
Saad Ruzzeh
author_sort Yousef El-Hamshari
collection DOAJ
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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spelling doaj-art-0cb589732e964e199ba40c36e29bf1052025-08-20T02:14:20ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802021-08-01150810.3855/jidc.14709The outcomes of severe COVID-19 pneumonia managed with supportive care in Palestine: an experience from a developing countryYousef El-Hamshari0Majdi Hamarshi1Zaher Nazzal2Amna Akkawi3Dana Saleh4Ibtesam Abdullah5Mohammed Najjar6Razan Rabi7Saad Ruzzeh8Martyrs Medical Military Hospital, Palestinian Ministry of HealthUniversity of Missouri, Kansas City, MO, United StatesFaculty of Medicine and Health Sciences, An-Najah National UniversityDr.Thabet Thabet Hospital, Palestinian Ministry of HealthRafidia Hospital, Palestinian Ministry of HealthDr.Thabet Thabet Hospital, Palestinian Ministry of HealthMartyrs Medical Military Hospital, Palestinian Ministry of HealthRafidia Hospital, Palestinian Ministry of HealthMartyrs Medical Military Hospital, Palestinian Ministry of Health 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%. https://jidc.org/index.php/journal/article/view/14709Supportive caresteroidsmortality ratesevere COVID-19risk factorsPalestine
spellingShingle Yousef El-Hamshari
Majdi Hamarshi
Zaher Nazzal
Amna Akkawi
Dana Saleh
Ibtesam Abdullah
Mohammed Najjar
Razan Rabi
Saad Ruzzeh
The outcomes of severe COVID-19 pneumonia managed with supportive care in Palestine: an experience from a developing country
Journal of Infection in Developing Countries
Supportive care
steroids
mortality rate
severe COVID-19
risk factors
Palestine
title The outcomes of severe COVID-19 pneumonia managed with supportive care in Palestine: an experience from a developing country
title_full The outcomes of severe COVID-19 pneumonia managed with supportive care in Palestine: an experience from a developing country
title_fullStr The outcomes of severe COVID-19 pneumonia managed with supportive care in Palestine: an experience from a developing country
title_full_unstemmed The outcomes of severe COVID-19 pneumonia managed with supportive care in Palestine: an experience from a developing country
title_short The outcomes of severe COVID-19 pneumonia managed with supportive care in Palestine: an experience from a developing country
title_sort outcomes of severe covid 19 pneumonia managed with supportive care in palestine an experience from a developing country
topic Supportive care
steroids
mortality rate
severe COVID-19
risk factors
Palestine
url https://jidc.org/index.php/journal/article/view/14709
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