Clinical characteristics and outcomes of critically ill patients with novel coronavirus infectious disease (COVID-19) in China: a retrospective multicenter study

Abstract

Purpose An ongoing outbreak of coronavirus disease 2019 (COVID-19) emerged in Wuhan since December 2019 and spread globally. However, information about critically ill patients with COVID-19 is still limited. We aimed to describe the clinical characteristics and outcomes of critically ill patients with COVID-19 and figure out the risk factors of mortality. Methods We extracted data retrospectively regarding 733 critically ill adult patients with laboratory-confirmed COVID-19 from 19 hospitals in China through January 1 to February 29, 2020. Demographic data, symptoms, laboratory values, comorbidities, treatments, and clinical outcomes were collected. The primary outcome was 28-day mortality. Data were compared between survivors and non-survivors. Results Of the 733 patients included in the study, the median (IQR) age was 65 (56–73) years and 256 (34.9%) were female. Among these patients, the median (IQR) APACHE II score was 10 (7 to 14) and 28-day mortality was 53.8%. Respiratory failure was the most common organ failure (597 [81.5%]), followed by shock (20%), thrombocytopenia (18.8%), central nervous system (8.6%) and renal dysfunction (8%). Multivariate Cox regression analysis showed that older age, malignancies, high APACHE II score, high d -dimer level, low PaO 2 /FiO 2 level, high creatinine level, high hscTnI level and low albumin level were independent risk factors of 28-day mortality in critically ill patients with COVID-19. Conclusion In this case series of critically ill patients with COVID-19 who were admitted into the ICU, more than half patients died at day 28. The higher percentage of organ failure in these patients indicated a significant demand for critical care resources. Electronic supplementary material The online version of this article (10.1007/s00134-020-06211-2) contains supplementary material, which is available to authorized users.

Critically ill patients with COVID-19: are they hemodynamically unstable and do we know why?

“…In summary, as suggested by Xie et al [1] and confirmed by Table 1, hemodynamic instability is common in COVID-19 ICU patients. However, the hemodynamic phenotype of patients receiving vasopressors remains poorly documented.…”

“…Indeed, a majority of them mentioned they had to administer vasopressors to ICU patients either frequently (> 50% of the cases) or very frequently (> 75%). Therefore, the rate of patients requiring vasopressor support reported by Xie et al [1] was on the low end of previous findings reported in the literature (Table 1).…”

“…More than 6 months after the inception of the coronavirus disease 2019 (COVID-19) pandemic, little has been published regarding the hemodynamic complications. We read with interest the multicenter case series published by Xie et al [1]. Although they focused on the lungs, like most reports on COVID-19 critically ill patients published so far, they also shared new information about the hemodynamic status of these patients.…”

COVID-19 in critical care: epidemiology of the first epidemic wave across England, Wales and Northern Ireland

“…other viral pneumonias (non-COVID- 19)]. We had a high level of completeness of outcome data (with only 3.8% still in acute hospital at database lock), comparing favourably with other reports [28][29][30] and we did not restrict our analyses to select groups. This study has limitations.…”

Letalität und Risikofaktoren für einen schweren Verlauf der COVID-19-Pneumonie

“…The value of laboratory surrogate markers specific for COVID-19 for risk estimation and treatment optimization cannot yet be adequately assessed. [15][16][17][18] Odds Ratio (95 %-KI)…”