Early vs late ICU admission in patients with COVID-19 pneumonia

Introduction: The type of admission to the Intensive Care Unit (ICU) influences the prognosis of patients with severe pneumonia and, in the case of patients with COVID-19 pneumonia, this is still unexplored. The objective of this study was to determine the differences between early and late ICU adm...

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Main Authors: Miguel Alejandro Pinzón, Santiago Ortiz, Henry Laniado, Nelson Javier Fonseca-Ruiz, Juan Felipe Betancur, Héctor Holguín, Pablo Montoya, Bernardo Javier Muñoz, Beatriz Ramírez, Carolina Arias Arias, Isabel Potes, Luz Maribel Toro, Julian Quiceno
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2024-09-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/18286
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author Miguel Alejandro Pinzón
Santiago Ortiz
Henry Laniado
Nelson Javier Fonseca-Ruiz
Juan Felipe Betancur
Héctor Holguín
Pablo Montoya
Bernardo Javier Muñoz
Beatriz Ramírez
Carolina Arias Arias
Isabel Potes
Luz Maribel Toro
Julian Quiceno
author_facet Miguel Alejandro Pinzón
Santiago Ortiz
Henry Laniado
Nelson Javier Fonseca-Ruiz
Juan Felipe Betancur
Héctor Holguín
Pablo Montoya
Bernardo Javier Muñoz
Beatriz Ramírez
Carolina Arias Arias
Isabel Potes
Luz Maribel Toro
Julian Quiceno
author_sort Miguel Alejandro Pinzón
collection DOAJ
description Introduction: The type of admission to the Intensive Care Unit (ICU) influences the prognosis of patients with severe pneumonia and, in the case of patients with COVID-19 pneumonia, this is still unexplored. The objective of this study was to determine the differences between early and late ICU admission. Methodology: A retrospective cohort study of patients with COVID-19 pneumonia at two high-complexity hospitals in Colombia. Early ICU admission (EICUA) was defined as direct admission from the emergency department or within the first 24 hours of admission. Late ICU admission (LICUA) was defined as admission from the hospitalization service after 24 hours of arrival. A robust Cox regression was performed for the variable recovery time, to determine the impact of the ICU admission type in the hazard rate. Results: 68.2% were EICUA patients and 31.8% were LICUA patients. Recovery and duration of hospital stay were significantly lower in EICUA than in LICUA (9 vs 15 days, p = 0.0001, and 10 vs 15.5 days, p < 0.0001, respectively). However, the duration of ICU stay (7 vs 9 days, p = 0.131) and the invasive mechanical ventilation requirement (48.9% vs 54.9%, p = 0.374) were not statistically significant. The 30-day follow-up showed no difference between the EICUA and LICUA (alive 97% vs 94.6%, p = 0.705). Conclusions: Mortality between EICUA and LICUA patients with COVID-19 pneumonia showed no statistically significant differences. However, the recovery time, the probability intensity of instant recovery, and the duration of hospital stay were better in EICUA than in LICUA. Neither EICUA nor LICUA affects the final status (death) of patients.
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publisher The Journal of Infection in Developing Countries
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spelling doaj-art-9eedc578689243688dd2feaa2156aba32025-08-20T02:14:11ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802024-09-01180910.3855/jidc.18286Early vs late ICU admission in patients with COVID-19 pneumoniaMiguel Alejandro Pinzón0Santiago Ortiz1Henry Laniado2Nelson Javier Fonseca-Ruiz3Juan Felipe Betancur4Héctor Holguín5Pablo Montoya6Bernardo Javier Muñoz7Beatriz Ramírez8Carolina Arias Arias9Isabel Potes10Luz Maribel Toro11Julian Quiceno12Department of Infectious Diseases, Clínica Medellín, Grupo Quirónsalud, Medellín, ColombiaFaculty of Engineering, Universidad de San Buenaventura, Cali, ColombiaDepartment of Mathematics, Universidad del Cauca, Popayán, ColombiaDepartment of Intensive Care, Nueva Clínica Sagrado Corazón, Medellín, ColombiaDepartment of Internal Medicine, Clínica Medellín, Grupo Quirónsalud, Medellín, ColombiaDepartment of Pharmacology, Clínica Medellín, Grupo Quirónsalud, Medellín, ColombiaDepartment of Internal Medicine, Clínica Medellín, Grupo Quirónsalud, Medellín, ColombiaDepartment of Pneumology, Clínica Medellín, Grupo Quirónsalud, Medellín, ColombiaDepartment of Epidemiology, Clínica Medellín, Grupo Quirónsalud, Medellín, ColombiaDepartment of Epidemiology, Universidad CES, Medellín, ColombiaDepartment of Epidemiology, Clínica Medellín, Grupo Quirónsalud, Medellín, ColombiaDepartment of Epidemiological Surveillance, Nueva Clínica Sagrado Corazón, Medellín, ColombiaDepartment of Internal Medicine, Clínica Medellín, Grupo Quirónsalud, Medellín, Colombia Introduction: The type of admission to the Intensive Care Unit (ICU) influences the prognosis of patients with severe pneumonia and, in the case of patients with COVID-19 pneumonia, this is still unexplored. The objective of this study was to determine the differences between early and late ICU admission. Methodology: A retrospective cohort study of patients with COVID-19 pneumonia at two high-complexity hospitals in Colombia. Early ICU admission (EICUA) was defined as direct admission from the emergency department or within the first 24 hours of admission. Late ICU admission (LICUA) was defined as admission from the hospitalization service after 24 hours of arrival. A robust Cox regression was performed for the variable recovery time, to determine the impact of the ICU admission type in the hazard rate. Results: 68.2% were EICUA patients and 31.8% were LICUA patients. Recovery and duration of hospital stay were significantly lower in EICUA than in LICUA (9 vs 15 days, p = 0.0001, and 10 vs 15.5 days, p < 0.0001, respectively). However, the duration of ICU stay (7 vs 9 days, p = 0.131) and the invasive mechanical ventilation requirement (48.9% vs 54.9%, p = 0.374) were not statistically significant. The 30-day follow-up showed no difference between the EICUA and LICUA (alive 97% vs 94.6%, p = 0.705). Conclusions: Mortality between EICUA and LICUA patients with COVID-19 pneumonia showed no statistically significant differences. However, the recovery time, the probability intensity of instant recovery, and the duration of hospital stay were better in EICUA than in LICUA. Neither EICUA nor LICUA affects the final status (death) of patients. https://jidc.org/index.php/journal/article/view/18286COVID-19pneumoniaintensive care unit admissionrobust proportional hazardrecovery time
spellingShingle Miguel Alejandro Pinzón
Santiago Ortiz
Henry Laniado
Nelson Javier Fonseca-Ruiz
Juan Felipe Betancur
Héctor Holguín
Pablo Montoya
Bernardo Javier Muñoz
Beatriz Ramírez
Carolina Arias Arias
Isabel Potes
Luz Maribel Toro
Julian Quiceno
Early vs late ICU admission in patients with COVID-19 pneumonia
Journal of Infection in Developing Countries
COVID-19
pneumonia
intensive care unit admission
robust proportional hazard
recovery time
title Early vs late ICU admission in patients with COVID-19 pneumonia
title_full Early vs late ICU admission in patients with COVID-19 pneumonia
title_fullStr Early vs late ICU admission in patients with COVID-19 pneumonia
title_full_unstemmed Early vs late ICU admission in patients with COVID-19 pneumonia
title_short Early vs late ICU admission in patients with COVID-19 pneumonia
title_sort early vs late icu admission in patients with covid 19 pneumonia
topic COVID-19
pneumonia
intensive care unit admission
robust proportional hazard
recovery time
url https://jidc.org/index.php/journal/article/view/18286
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