Impact of Respiratory Comorbidities on Coronavirus Disease 2019 Outcomes of Intensive Care Unit Patients: A Retrospective Study
Authors: Aleid Abdulsalam Mohammed , Althikrallah Farah Mohammed , Alharbi Roaa Qussai , Alserhani Abdulaziz Saeed , Alqahtani Nouf Mohsen , Abdulmajeed Tala Khalid , Koshak Hamza Adnan , Kharaba Ayman 
Published: December 2024

Abstract

Introduction:
The novel coronavirus disease 2019 (COVID-19) has become a global health concern, frequently requiring critical care support, including mechanical ventilation (MV), for severe illness. Pre-existing respiratory diseases put patients at higher risk for infection, but little is known about how these conditions progress and what their chances are when they become life-threatening. This retrospective study examined relationships between key outcomes in COVID-19 patients admitted to the intensive care unit (ICU) of a tertiary care hospital and those with a history of chronic respiratory diseases including chronic lung disease (CLD), chronic obstructive pulmonary disease (COPD) and bronchial asthma. A population that is at risk may benefit from insights that help identify high-risk groups and direct evidence-based management strategies that optimise clinical outcomes.

Methods:
This study has, therefore, presented a consecutive analysis of 1102 COVID-19 patients admitted to the ICU between 22 June and 22 October 2020. Demographic data, clinical characteristics, ICU outcomes and survival were analysed. Associations between respiratory comorbidities (comorbidities specifically CLDs and COPD and bronchial asthma) and the results were evaluated. IBM SPSS version 28.0 for Windows was used for data analysis. For categorical variables, demographic variables, outcomes and comorbidities, descriptions of frequencies and percentages were used to give an overall description of the study population, whereas for continuous variables, mean ± standard deviation (SD) was calculated for continuous variables. After that, the Chi-square tests were included in the research to determine the dependability of two or more categorical variables. The numerical variables were analysed for the significance of association, and this was done using the Mann–Whitney U-test. All tests were two-sided and P < 0.05 was considered statistically significant. 05 was significant.

Results:
A retrospective review was conducted of 1102 consecutive COVID-19 patients admitted to the ICU between June and October 2022. The mean age was 56 years and 74.6% were males. MV was utilised in 83.2%, with a mean duration of 13.84 days. CLD, COPD and bronchial asthma affected 3.0%, 1.7% and 8.0%, respectively. The results of the study also indicated that the patients with the respiratory comorbidities did not require a longer ICU/hospital stay or MV than patients without these comorbidities. Microbiological cure occurred in 15.6%, with 92.7% discharged alive from ICU within 28 days. ICU mortality was 37.2% and hospital mortality – 38.5%. Respiratory comorbidities did not impact microbiological cure, 28-day ICU discharge, ICU or hospital mortality rates.

Conclusion:
Unlike the other ethnic disparities cited above, prior comorbidities such as CLD, COPD or asthma did not seem to impact on critically ill COVID-19 patients requiring ICU beds. MV use and benefits appeared comparable between those with and without respiratory disease. Prospective validation of impact on longer term functional recovery is warranted. Standardised strategies optimising modifiable risk factors such as obesity alongside evidence-based respiratory support may maximise outcomes in this high-risk group.