ICU mortality of covid-19 patients – our experience
Authors:
Radka Čapková; Stanislav Ševela; Hana Petrášková; Marie Ryšánková; Radan Brůha
Authors‘ workplace:
IV. interní klinika, Všeobecná fakultní nemocnice v Praze a 1. LF UK, Praha
Published in:
Vnitř Lék 2021; 67(E-5): 23-27
Category:
Original Contributions
Overview
Objectives: To determinate characteristics of covid-19 patients in our ICU, to determinate mortality and presence of comorbidities considered as risk factor for severe course of disease.
Methods: Retrospective observation study in ICU with 5–8 beds. Population of 91 adults with covid-19 admitted to ICU.
Results: Median age was 67 years (38–88). Hypertension (56 patients, 61 %) and diabetes (35 patients, 38 %) were the most common comorbidities. 24 patients (26 %) were obese with BMI 30–40, 10 patients (11 %) with BMI > 40. Average SOFA score on admission was 3,5 (1–10). HFNO (high flow nasal oxygen) therapy was the highest ventilation support used in 14 (15 %) patients (while 9 (64 %) of them had limitation of therapy by order D.N.I.), NIV (non-invasive ventilation) in 17 (18 %) patients (9 of them (52 %) had limitation of therapy with order D.N.I.). Conditions of 37 (40 %) patients required intubation and invasive mechanical ventilation. Overall mortality in our cohort was 37 %. Mortality of patients with 2 or more comorbidities was 46 %, mortality of patients without comorbidities was 44 % (in total 4 patients with high age). The highest mortality was in the group of patients 80–90 years (89 %). Mortality in the group of patients younger than 50 years was surprisingly high (27 %), but these were 3 patients in total. Mortality of patients requiring IPV was 43 %.
Conclusion: Mortality of covid-19 patients in our ICU was 37 % which is much higher than mortality in the same period in 2019 and 2020 before the beginning of pandemic. Mortality increased with higher age. Almost all our patients had at least one of the comorbidities mentioned above.
Keywords:
age – mortality – comorbidities – COVID-19 – intensive care unit (ICU) – D.N.I. (do not intubate) – high flow nasal oxygen (HFNO) therapy – invasive mechanical ventilation – non-invasive ventilation (NIV)
Sources
1. Auld SC, Caridi-Scheible M, Blum JM et al. ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019, Crit Care Med. 2020; 48(9): e799–e804.
2. Kümpel P, Holub M, Roháčová H, Plíšek S. Doporučený postup SIL ČLS JEP léčby pacientů s onemocněním covid-19, dostupné na https://www.infekce.cz/Covid2019/DP-SIL- covid29p.pdf.
3. Wang D, Hu B, Hu C et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; 323(11): 1061–1069. doi:10.1001/jama. 2020.1585.
4. Zhou F, Yu T, Du R et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229): 1054–1062. doi: 10.1016/S0140-6736(20)30566-3.
5. Richardson S, Hirsch JS, Narasimhan M et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA – J Am Med Assoc. 2020; 323(20): 2052–2059.
6. Zhang B, Zhou X, Qiu Y et al. Clinical characteristics of 82 cases of death from COVID-19. PLoS One. 2020; 15(7): e0235458. doi: 10.1371/journal.pone.0235458. eCollection 2020. PMID: 32645044.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2021 Issue E-5
Most read in this issue
- D-lactic acidosis – a rare complication of short bowel syndrome
- Whipple disease – systemic disease with gastrointestinal manifestations
- Retrospective analysis of the incidence of pulmonary embolism in CT images in patients with a positive value of D-dimers
- Do we care enough about the medication in the elderly? (Case of the geriatric care facility at Military University Hospital Prague)