First COVID-19 sub-intensive respiratory unit in Europe: the Italian experience

Henchi, Sonia; Conti, Clara Benedetta; Vanoni, Nicolò; Repossi, Alice; Cipolla, Giuseppe; Marra, Mirko; Esposti, Elena; Fiini, Michela; Cominesi, Irene Raimondi; Crepaldi, Monica; Scozzafava, Mariano

doi:10.4081/mrm.2020.682

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…Indeed, in our RICU, 51% of patients admitted were discharged to GW, 30% was transferred to ICU and 19% died. Instead, in Lodi experience, 64% of patients were discharged, 18% were transferred to ICU and 18% died [ 22 ]. However, a comparison with the characteristics of COVID-19 patients treated in Lodi Sub- Intensive Respiratory Unit was not possible, because the data about the severity of patients’ clinical conditions are not reported.…”

Section: Discussionmentioning

confidence: 99%

Baseline characteristics and outcomes of COVID-19 patients admitted to a Respiratory Intensive Care Unit (RICU) in Southern Italy

et al. 2020

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The recent Coronavirus disease 19 (COVID-19) pandemic, first in China and then also in Italy, brought to the attention the problem of the saturation of Intensive Care Units (ICUs). Almost all previous reports showed that in ICU less than half of patients were treated with invasive mechanical ventilation (IMV) and the rest of them with non-invasive respiratory support. This highlighted the role of respiratory intensive care units (RICUs), where patients with moderate to severe respiratory failure can be treated with non-invasive respiratory support, avoiding ICU admission. In this report, we describe baseline characteristics and clinical outcomes of 97 patients with moderate to severe respiratory failure due to COVID-19 admitted to the RICU of the Policlinico of Bari from March 11th to May 31st 2020. In our population, most of the subjects were male (72%), non-smokers (76%), with a mean age of 69.65±14 years. Ninety-one percent of patients presented at least one comorbidity and 60% had more than two comorbidities. At admission, 40% of patients showed PaO2/FiO2 ratio between 100 and 200 and 17% showed Pa02/FiO2 ratio <100. Mean Pa02/FiO2 ratio at admission was 186.4±80. These patients were treated with non-invasive respiratory support 40% with CPAP, 38% with BPAP, 3% with HFNC, 11% with standard oxygen therapy or with IMV through tracheostomy (patients in step down from ICU, 8%). Patients discharged to general ward (GW) were 51%, 30% was transferred to ICU and 19% died. To the best of our knowledge, this is one of the few described experiences of patients with respiratory failure due to COVID-19 treated outside the ICU, in a RICU. Outcomes of our patients, characterized by several risk factors for disease progression, were satisfactory compared with other experiences regarding patients treated with non-invasive respiratory support in ICU. The strategical allocation of our RICU, between ED and ICU, might have positively influenced clinical outcomes of our patients.

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Section: Discussionmentioning

confidence: 99%

Baseline characteristics and outcomes of COVID-19 patients admitted to a Respiratory Intensive Care Unit (RICU) in Southern Italy

et al. 2020

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“…This condition prompted a rapid reorganization of hospital facilities, culminating in the establishment of Europe's first Sub-intensive Respiratory Unit entirely dedicated to COVID-19 patients in Northern Italy. 6 Following the summer period's reduction in contagions, a second epidemic wave has engulfed the country since the end of October 2020, with a third wave expected in March 2021. The global impacts on the economic, social, and health domains resulted in an exponential increase in medical literature from independent groups and global coalitions, 7 with a corresponding decrease in scientific publication quality.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 in sub-intensive care unit: An italian single-center experience along the three epidemic waves

et al. 2022

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The goal was to characterize COVID-19 patients who needed treatment in Sub-Intensive Care Units (SICUs) for hypoxemic respiratory failure, describe their six-month mortality, and identify clinical and laboratory characteristics that were associated with death. Data from 216 consecutive patients admitted to the COVIDSICU of Turin’s San Giovanni Bosco Hospital were analyzed retrospectively. A total of 216 patients (24.5% of whom were female) were enrolled. The average age was 63±11.9 years. In the three waves, the six-month mortality rate was 32.8%, 35.1%, and 26.6%, respectively (p=0.52). The mortality rate was significantly higher in intubated patients compared to those not requiring intubation (60.8% versus 29.9%, p<0.01). On admission, deceased patients were older (69±7.7 versus 60.2±12.6 y.o., p<0.01), with a higher prevalence of dyslipidemia, coronary artery disease, chronic heart failure, and higher serum creatinine. However, only age was predictive of death at multivariate analysis (OR 5.29, p<0.01), with 63 years old as the best cut-point. At six months, mortality in COVID patients managed in a SICU is around 30%. Age is a significant negative prognostic factor, with 63 years of age being the best predicting cut-off.

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First COVID-19 sub-intensive respiratory unit in Europe: the Italian experience

Cited by 2 publications

References 15 publications

Baseline characteristics and outcomes of COVID-19 patients admitted to a Respiratory Intensive Care Unit (RICU) in Southern Italy

Baseline characteristics and outcomes of COVID-19 patients admitted to a Respiratory Intensive Care Unit (RICU) in Southern Italy

COVID-19 in sub-intensive care unit: An italian single-center experience along the three epidemic waves

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