Clinical course and features of critical patients with COVID-19: a single- center, retrospective study from Wuhan Huoshenshan Hospital

Abstract

Background : The coronavirus pandemic has become a growing public health concern worldwide, and there are insufficient epidemiological data on critical illness. Objective: To investigate the clinical course and features of critical patients with Corona Virus Disease 2019 ( COVID-19 ). Methods: The data on 94 consecutive critical patients from 8 th February through 16 th March 2020, including demographic and clinical information, were obtained from the intensive care unit (ICU) of Wuhan Huoshenshan Hospital. A cross-sectional survey and comparisons of key biomarkers between survivors and nonsurvivors were performed. Results: Over the study period, 42 nonsurvivors and 52 survivors were included. The overall case fatality rate for critical patients with COVID-19 was approximately 45%. The average age was 69.17±9.55 years, and the majority had underlying health problems such as hypertension (56[60%]) and diabetes (18[19%]). The median length of ICU stay was 8 days (IQR 4, 13). Compared with survivors, nonsurvivors were more likely to develop sepsis (42[100%] vs. 34[65%]), acute respiratory distress syndrome (40[95%] vs. 28[54%]) and organ dysfunction. In addition, the dynamic changes in some biomarkers were significantly different between the two groups. The trajectories of temperature revealed that the group with a high temperature on admission that steadily declined had the highest percentage of deaths (93.33%). Conclusions: Patients aged 60 years or older with many concomitant diseases were at highest risk, and the fatality rate started to increase with age. Lymphocyte, platelet, C-reactive protein and hypersensitivity troponin I were revealed to have potential as prognostic factors, whereas some other biomarkers, such as hepatic enzymes, may not offer additional information. Moreover, patients with high temperatures on admission should receive extra care.