Timing and causes of death in severe COVID-19 patients

Abstract

Background Previous studies reporting the causes of death in patients with severe COVID-19 have provided conflicting results. The objective of this study was to describe the causes and timing of death in patients with severe COVID-19 admitted to the intensive care unit (ICU). Methods We performed a retrospective study in eight ICUs across seven French hospitals. All consecutive adult patients (aged ≥ 18 years) admitted to the ICU with PCR-confirmed SARS-CoV-2 infection and acute respiratory failure were included in the analysis. The causes and timing of ICU deaths were reported based on medical records. Results From March 1, 2020, to April 28, 287 patients were admitted to the ICU for SARS-CoV-2 related acute respiratory failure. Among them, 93 patients died in the ICU (32%). COVID-19-related multiple organ dysfunction syndrome (MODS) was the leading cause of death (37%). Secondary infection-related MODS accounted for 26% of ICU deaths, with a majority of ventilator-associated pneumonia. Refractory hypoxemia/pulmonary fibrosis was responsible for death in 19% of the cases. Fatal ischemic events (venous or arterial) occurred in 13% of the cases. The median time from ICU admission to death was 15 days (25th–75th IQR, 7–27 days). COVID-19-related MODS had a median time from ICU admission to death of 14 days (25th–75th IQR: 7–19 days), while only one death had occurred during the first 3 days since ICU admission. Conclusions In our multicenter observational study, COVID-19-related MODS and secondary infections were the two leading causes of death, among severe COVID-19 patients admitted to the ICU.

Outcomes of Patients With Active Cancer and COVID-19 in the Intensive-Care Unit: A Multicenter Ambispective Study

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National early warning score (NEWS) 2 predicts hospital mortality from COVID-19 patients

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Global Research Status of Multiple Organ Dysfunction Syndrome During 2001–2021: A 20-Year Bibliometric Analysis

“…The high fatality rate of coronavirus disease (COVID- 19) has posed a serious challenge to global health and epidemic prevention, and the latest research shows that this is closely related to the later progression of severe COVID-19 patients to Multiple Organ Dysfunction Syndrome (MODS) (1,2). MODS is defined as the acute and potentially reversible dysfunction of two or more organs triggered by multiple clinical or non-clinical factors.…”