risk factors of death in mechanically ventilated covid-19 patients: a multi-center study from iran

Despite the improvement in covid-19 therapeutic management the mortality of mechanically ventilated covid-19 patients remains high. in this study, we determined the risk factors of death in these cases. this cross-sectional study evaluated clinical and paraclinical features of mechanically ventilated covid-19 patients at the time of hospital admission until death or discharge from hospital between april and september in 2021 in three covid-19 referral hospitals. the patients were divided into survivors and non survivors and then the characteristics were compared. one hundred twenty-five patients (60% male, mean age 62±15.18, range 17 to 97 years old) were recruited to the study. 51(40%) survived and 74 (60%) didn’t survive. at the time of hospital admission, the vital signs were not significantly different between the survivors and non-survivors, although diarrhea was not reported in non-survivors, but reported in 9.5% of survivors (p=0.02). the mean age of non-survivors was higher (65.1±14.17 vs 56.9±15.41, p=0.003). the intubation time since the patients were admitted was not significantly different between the two groups (3.38±2.88 days vs 4.16±3.42 days, p=0.34). the mean of serum ldh and d-dimer at the time of icu admission were significantly higher in the non-survivors (863±449 vs 613±326, p=0.01; 4081±3342 vs 542±634, p=0.009; respectively). however, the mean crp was not significantly different between the two groups (76±66.4, 54±84.3; p=0.1). mean apache-ii score was higher in the non-survivors than the survivors (15 vs 13; p=0.01). use of remdesivir, interferon beta-1a, and low dose corticosteroids were significantly higher in the survivors group (p=0.009, p=0.001, p=0.000). success of weaning and icu discharge among mechanically ventilated covid-19 patients are probably higher in younger patients with lower d-dimmer and ldh that received remdesivir, interferon beta-1a and low dose corticosteroids, while the intubation time did not seem to play a role on patients' outcome.