ORIGINAL RESEARCH article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1634256
Risk Factors for Intensive Care Unit Admission among COVID-19 Patients in the West Bank, Palestine: A Retrospective Cohort Study
Provisionally accepted
- 1An-najah National University Faculty of Medicine and Health Sciences, Nablus, Palestine
- 2Arab American University of Jenin, Jenin, Palestine
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COVID-19 has significantly strained healthcare systems worldwide, particularly in resourcelimited and conflict-affected regions such as Palestine. Understanding the risk factors for intensive care unit (ICU) admission is essential for effective triage and resource allocation.This study aimed to identify demographic, clinical, and laboratory predictors of ICU admission among hospitalized COVID-19 patients in governmental hospitals across the West Bank, Palestine.A retrospective cohort study was conducted across six designated COVID-19 treatment hospitals from November 2020 to February 2021. Medical records of 200 adult patients with PCR-confirmed COVID-19 were reviewed. Patients were grouped based on ICU versus general ward admission. Bivariate analyses, multivariate logistic regression, and Cox proportional hazards models were employed to identify independent predictors of ICU admission and to evaluate the time to ICU transfer.Of the 200 patients, 117 (58.5%) were admitted to the ICU. Multivariate logistic regression identified obesity (OR = 66.7, p < 0.001), hospital site (p = 0.001), white blood cell count (OR = 1.25, p = 0.005), and blood urea nitrogen (OR = 0.96, p = 0.007) as significant positive predictors. Random blood sugar (OR = 0.99, p = 0.014) was inversely associated with ICU admission. Kaplan-Meier and Cox-regression analyses further revealed that obesity, low PaO₂, low BUN, low RBS, pregnancy, and pneumonia significantly shortened the time to ICU admission (all p < 0.05). Conversely, age, gender, comorbidities, and chief complaints were not independently associated with ICU admission.This is the first study in Palestine to comprehensively evaluate ICU admission risk factors among COVID-19 patients. Our findings can inform ICU triage protocols and help shape evidence-based health policies tailored to the Palestinian context and could establish data base for new similar future pandemics and/or resurge of COVID-19 for better emergency preparedness and intervention measures.
Keywords: COVID-19, Icu admission, Risk factors, Palestine, Retrospective cohort, Obesity, Coxregression
Received: 23 May 2025; Accepted: 29 Jul 2025.
Copyright: © 2025 Khalid, Al Zabadi, Qaddumi and Taha. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hamzeh Al Zabadi, An-najah National University Faculty of Medicine and Health Sciences, Nablus, Palestine
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