Clinical Findings of COVID-19 Patients Admitted to Intensive Care Units in Guangdong Province, China: A Multicenter, Retrospective, Observational Study

Abstract

Background: Information about critically ill patients with coronavirus disease 2019 (COVID-19) in China but outside of Wuhan is scarce. We aimed to describe the clinical features, treatment, and outcomes of patients with COVID-19 admitted to the intensive care unit (ICU) in Guangdong Province. Methods: In this multicenter, retrospective, observational study, we enrolled consecutive patients with COVID-19 who were admitted to seven ICUs in Guangdong Province. Demographic data, symptoms, laboratory findings, comorbidities, treatment, and outcomes were collected. Data were compared between patients with and without intubation. Results: A total of 45 COVID-19 patients required ICU admission in the study hospitals [mean age 56.7 ± 15.4 years, 29 males (64.4%)]. The most common symptoms at onset were fever and cough. Most patients presented with lymphopenia and elevated lactate dehydrogenase. Treatment with antiviral drugs was initiated in all patients. Thirty-six patients (80%) developed acute respiratory distress syndrome at ICU admission, and 15 (33.3%) septic shock. Twenty patients (44.4%) were intubated, and 10 (22.2%) received extracorporeal membrane oxygenation. The 60-day mortality was 4.4% (2 of 45). Conclusion: COVID-19 patients admitted to ICU were characterized by fever, lymphopenia, acute respiratory failure, and multiple organ dysfunction. The mortality of ICU patients in Guangdong Province was relatively low with a small sample size.

Critical Care Response to the Outbreak of COVID-19: The Experience From Guangdong Province, China

“…Distinct from the characteristics of critically ill COVID-19 patients reported in Wuhan and other epicenters of the outbreak ( 4 – 7 ), patients in Guangdong were managed by a group of trained intensivists and specialist nurses with sufficient ventilators, extracorporeal membrane oxygenation (ECMO) equipment, and personal protective equipment. Moreover, as shown in our preprint data ( 12 ), the relatively low APACHE II and SOFA scores (the median APACHE II and SOFA scores was 14 and 4.0, respectively), of all patients at ICU admission indicated that fewer critically ill patients were admitted to the ICU to receive high intensity monitoring and prompt intensive care interventions. Besides, in our preprint study, 9 patients received ECMO due to a low but not too low PaO 2 /FiO 2 ratio [85.2 (58.3–103.4) mmHg] or a high but not too high PaCO 2 level [59.2 (53.5–68.9) mmHg], indicating early ECMO was initiated in patients presenting rapidly progressive respiratory failure (criteria for ECMO initiation: PaO 2 /FiO 2 from 120 to 100 mmHg and/or PaCO 2 from 50 to 55 mmHg, <4 h).…”

Comparison of first and second waves of COVID-19 through severity markers in ICU patients of a developing country

“…Another study of 45 patients including 20 intubated patients had APACHE-II score of 14 and SOFA score of 4 showing a higher risk for intubation. Additionally, SOFA score correlated with lymphocytopenia and elevated LDH [27].…”

Clinical profile and short-term outcomes of RT-PCR positive COVID-19 patients in a tertiary care hospital in Dhaka, Bangladesh

“…Around 9.35% of patients included in this study were asymptomatic during the initial assessment. Fever and respiratory symptoms were most common among the patients, reported in numerous other studies [21,27,28]. While several studies from China [28,29], Uzbekistan [30], and Brazil [31] reported weakness or fatigue as a common symptom, only 8% (n = 31 out of 377) of the patients reported that they experienced weakness during initial triage at the hospital.…”

“…The lower SpO2 level or severe illness was signi cantly associated with older age and the presence of any comorbidity. Besides, the severe illness was signi cantly associated with radiological ndings of Pneumonia [34], higher creatinine [27,35], c-reactive protein [20,35], and Neutrophil Lymphocyte ratio [36][37][38]. A higher proportion of patients with low SpO2 levels frequently received antibiotics, anticoagulants, and glucocorticoid therapy.…”