COVID-19 severe pneumonia: Prospective multicentre study on demands on intensive care capacities

Abstract

Objectives: The aim of the study was to obtain data on demands on the intensive care capacities to treat COVID-19 patients, and to identify predictors for in-hospital mortality.Methods: The prospective observational multicentre study carried out from 1 March till 30 June 2020 included adult patients with confirmed SARS-CoV-2 infection with respiratory failure requiring ventilatory support or high-flow nasal oxygen therapy (HFNO).Results: Seventy-four patients, 46 males and 28 females, median age 67.5 (Q1-Q3: 56-75) years, were included. Sixty-four patients (86.5%) had comorbidity. Sixty-six patients (89.2%) were mechanically ventilated, four of them received extracorporeal membrane oxygenation therapy. Eight patients (10.8%) were treated with non-invasive ventilation and HFNO only. The median of intensive care unit (ICU) stay was 22.5 days. Eighteen patients (24.3%) needed continuous renal replacement therapy. Thirty patients (40.5%) died. Age and acute kidney injury were identified as independent predictors of in-hospital death, and chronic kidney disease showed trend towards statistical significance for poor outcome.Conclusions: Sufficient number of intensive care beds, organ support equipment and well-trained staff is a decisive factor in managing the COVID-19 epidemic. The study focused on the needs of intensive care in the COVID-19 patients. Advanced age and acute kidney injury were identified as independent predictors for in-hospital mortality. When compared to clinical course and ICU management of patients with severe community-acquired pneumonia caused by other pathogens, we observed prolonged need for ventilatory support, high rate of progression to acute respiratory distress syndrome and significant mortality in studied population.

Recent Advance Analysis of Recovery in Hospitalized People with COVID-19: A Systematic Review

“…Characteristics of patients and included studies are shown in Table S3 . Patients were hospitalized in a hospital ward [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ] or ICU [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ] and studies were conducted in different countries (Andorra [ 38 ], Belgium [ 29 ], Brazil [ 14 ], China [ 15 , 16 ], Czech Republic [ 28 ], Denmark [ 17 ], France [ 18 , 19 , 20 , 29 ], India [ 30 ], Italy [ 31 ], Mexico [ 22 , 23 , 32 ], Norway [ 24 ], Poland [ 25 ], Spain [ 26 , 33 , 34 ,…”

“…Abbreviations: USA = United States of America; UK = United Kingdom; IC = confidence interval. References: Brandão et al [ 14 ]; Cao et al [ 15 ]; Yang et al [ 16 ]; Madsen et al [ 17 ]; Jourdes et al [ 18 ]; Kaeuffer et al [ 19 ]; Allenbach et al [ 20 ]; Giacomelli et al [ 21 ]; Cortes-Telles et al [ 22 ]; Olivas-Martínez et al [ 23 ]; Myrstad et al [ 24 ]; Piwowarczyk et al [ 25 ]; Rodriguez-Molinero et al [ 26 ]; Roberts et al [ 27 ]; Dzupová et al [ 28 ]; Schmidth et al [ 29 ]; Kayina et al [ 30 ]; Radovanovic et al [ 31 ]; Namedys-Silva et al [ 32 ]; Estella et al [ 33 ]; Barrasa et al [ 34 ]; Rodríguez et al [ 35 ]; Pineiro et al [ 36 ]; Taboada et al [ 37 ]; Ferrando et al [ 38 ]; Larsson et al [ 39 ]; Thomson et al [ 40 ]; Gupta et al [ 41 ]; Molnar et al [ 42 ]; Cummings et al [ 43 ].…”

“…Abbreviations: ARDS = acute respiratory distress syndrome; USA = United States of America; IC = confidence interval. References: Cao et al [ 15 ]; Madsen et al [ 17 ]; Olivas-Martínez et al [ 23 ]; Piwowarczyk et al [ 25 ]; Dzupová et al [ 28 ]; Schmidth et al [ 29 ]; Rodríguez et al [ 35 ]; Ferrando et al [ 38 ]; Gupta et al [ 41 ]; Molnar et al [ 42 ].…”

“…Abbreviations: ARDS = acute respiratory distress syndrome; USA = United States of America; UK = United Kingdom; IC = confidence interval. References: Brandão et al [ 14 ]; Cao et al [ 15 ]; Madsen et al [ 17 ]; Allenbach et al [ 20 ]; Jourdes et al [ 18 ]; Giacomelli et al [ 21 ]; Myrstad et al [ 24 ]; Roberts et al [ 27 ]; Dzupová et al [ 28 ]; Radovanovic et al [ 31 ]; Rodríguez et al [ 35 ]; Pineiro et al [ 36 ]; Larsson et al [ 39 ]; Gupta et al [ 41 ]; Thomson et al [ 40 ]; Cummings et al [ 43 ].…”

Delayed mechanical ventilation with prolonged high-flow nasal cannula exposure time as a risk factor for mortality in acute respiratory distress syndrome due to SARS-CoV-2

“…In addition to the studied variable (time between HFNC initiation and IMV initiation), the study included ten events of mortality for each confounding variable assessed, for a total of 12 confounders. Assuming an expected mortality of 40% [ 29 ], the required sample size was 325 patients.…”