中国杭州市重症监护室34 例covid-19 患者临床特点的分析

Abstract

from Jan. 22 to Mar. 5, 2020. Methods: A total of 34 patients were divided into two groups, including those who required noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) with additional extracorporeal membrane oxygenation (ECMO) in 11 patients. Clinical features of COVID-19 patients were described and the parameters of clinical characteristics between the two groups were compared. Results: The rates of the acute cardiac and kidney complications were higher in IMV cases than those in NIV cases. Most patients had lymphocytopenia on admission, with lymphocyte levels dropping progressively on the following days, and the more severe lymphopenia developed in the IMV group. In both groups, T lymphocyte counts were below typical lower limit norms compared to B lymphocytes. On admission, both groups had higher than expected amounts of plasma interleukin-6 (IL-6), which over time declined more in NIV patients. The prothrombin time was increased and the levels of platelet, hemoglobin, blood urea nitrogen (BUN), D-dimer, lactate dehydrogenase (LDH), and IL-6 were higher in IMV cases compared with NIV cases during hospitalization. Conclusions: Data showed that the rates of complications, dynamics of lymphocytopenia, and changes in levels of platelet, hemoglobin, BUN, D-dimer, LDH and IL-6, and prothrombin time in these ICU patients were significantly different between IMV and NIV cases.

COVID-19 ICU and Mechanical Ventilation Patient Characteristics and Outcomes - A Systematic Review and Meta-analysis

“…When a mean value of a continuous outcome was missing, methods by Wan [7] were utilized to impute the needed value for the meta-analysis. Since some studies [8,9,[10][11][12][13][14][15][16][17][18][19][20][21][22][23] included patients still hospitalized at endpoint (n=4,697, 37.8%), we considered two mortality scenarios methodologically: (1) best case scenario by pooling patients with known outcome and (2) worst case scenario by pooling those still hospitalized with non-survivors.…”

“…Of these, 6,875 patients were on IMV. Nine studies were from the USA [8][9][10][11]17,18,23,25,26], 13 from China [12,14,16,[20][21][22][27][28][29][30][31][32][33], two from the UK [24,32], and one each from Italy [15], Spain [13], France [19], and Mexico [35]. (Table 1) Fifteen studies were good and 13 were fair as assessed by the NIH tool.…”

“…Follow-up duration was insu cient or unreported in seven [8,10,12,14,26,29,35] among which three had fair assessments. Of note, 14 studies [8,9,[12][13][14][15][17][18][19]21,22,24,25,34] had over 20% of patients with unknown outcome at endpoint of which 8 had fair assessment. Figure 3).…”

Savable but lost lives when ICU is overloaded: a model from 733 patients in epicenter Wuhan, China

“…5 Computational Health Informatics Program (CHIP), Boston Children's Hospital, Harvard Medical School, Boston, 02215, MA, USA. 6 Department of Critical Care Medicine, The First A liated Hospital of Guangxi Medical University, Guangxi, 530021, China.…”

“…The analysis, modeling and forecasting of clinical characteristics for patients diagnosed with COVID-19, are of great signi cance for the evaluation of new severe patients. Many scholars have done abundantly research on the clinical manifestations, epidemiological characteristics and treatment methods of infected patients [3,[5][6][7][8][9][10][11][12][13][14][15].…”