tetano
Editor, Senior Moderator
CMAJ Open
. 2020 Nov 24;8(4):E788-E795.
doi: 10.9778/cmajo.20200159. Print Oct-Dec 2020.
Outcomes and clinical practice in patients with COVID-19 admitted to the intensive care unit in Montr?al, Canada: a descriptive analysis
Stephen Su Yang[SUP] 1 [/SUP], Jed Lipes[SUP] 2 [/SUP], Sandra Dial[SUP] 2 [/SUP], Blair Schwartz[SUP] 2 [/SUP], Denny Laporta[SUP] 2 [/SUP], Evan Wong[SUP] 2 [/SUP], Craig Baldry[SUP] 2 [/SUP], Paul Warshawsky[SUP] 2 [/SUP], Patricia McMillan[SUP] 2 [/SUP], David Hornstein[SUP] 2 [/SUP], Michel de Marchie[SUP] 2 [/SUP], Dev Jayaraman[SUP] 2 [/SUP]
Affiliations
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic is responsible for millions of infections worldwide, and a substantial number of these patients will be admitted to the intensive care unit (ICU). Our objective was to describe the characteristics, outcomes and management of critically ill patients with COVID-19 pneumonia at a single designated pandemic centre in Montr?al, Canada.
Methods: A descriptive analysis was performed on consecutive critically ill patients with COVID-19 pneumonia admitted to the ICU at the Jewish General Hospital, a designated pandemic centre in Montr?al, between Mar. 5 and May 21, 2020. Complete follow-up data corresponding to death or discharge from hospital health records were included to Aug. 4, 2020. We summarized baseline characteristics, management and outcomes, including mortality.
Results: A total of 106 patients were included in this study. Twenty-one patients (19.8%) died during their hospital stay, and the ICU mortality was 17.0% (18/106); all patients were discharged home or died, except for 4 patients (2 awaiting a rehabilitation bed and 2 awaiting long-term care). Twelve of 65 patients (18.5%) requiring mechanical ventilation died. Prone positioning was used in 29 patients (27.4%), including in 10 patients who were spontaneously breathing; no patient was placed on extracorporeal membrane oxygenation. High-flow nasal cannula was used in 51 patients (48.1%). Acute kidney injury was the most common complication, seen in 20 patients (18.9%), and 12 patients (11.3%) required renal replacement therapy. A total of 53 patients (50.0%) received corticosteroids.
Interpretation: Our cohort of critically ill patients with COVID-19 had lower mortality than that previously described in other jurisdictions. These findings may help guide critical care decision-making in similar health care systems in further COVID-19 surges.
. 2020 Nov 24;8(4):E788-E795.
doi: 10.9778/cmajo.20200159. Print Oct-Dec 2020.
Outcomes and clinical practice in patients with COVID-19 admitted to the intensive care unit in Montr?al, Canada: a descriptive analysis
Stephen Su Yang[SUP] 1 [/SUP], Jed Lipes[SUP] 2 [/SUP], Sandra Dial[SUP] 2 [/SUP], Blair Schwartz[SUP] 2 [/SUP], Denny Laporta[SUP] 2 [/SUP], Evan Wong[SUP] 2 [/SUP], Craig Baldry[SUP] 2 [/SUP], Paul Warshawsky[SUP] 2 [/SUP], Patricia McMillan[SUP] 2 [/SUP], David Hornstein[SUP] 2 [/SUP], Michel de Marchie[SUP] 2 [/SUP], Dev Jayaraman[SUP] 2 [/SUP]
Affiliations
- PMID: 33234586
- DOI: 10.9778/cmajo.20200159
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic is responsible for millions of infections worldwide, and a substantial number of these patients will be admitted to the intensive care unit (ICU). Our objective was to describe the characteristics, outcomes and management of critically ill patients with COVID-19 pneumonia at a single designated pandemic centre in Montr?al, Canada.
Methods: A descriptive analysis was performed on consecutive critically ill patients with COVID-19 pneumonia admitted to the ICU at the Jewish General Hospital, a designated pandemic centre in Montr?al, between Mar. 5 and May 21, 2020. Complete follow-up data corresponding to death or discharge from hospital health records were included to Aug. 4, 2020. We summarized baseline characteristics, management and outcomes, including mortality.
Results: A total of 106 patients were included in this study. Twenty-one patients (19.8%) died during their hospital stay, and the ICU mortality was 17.0% (18/106); all patients were discharged home or died, except for 4 patients (2 awaiting a rehabilitation bed and 2 awaiting long-term care). Twelve of 65 patients (18.5%) requiring mechanical ventilation died. Prone positioning was used in 29 patients (27.4%), including in 10 patients who were spontaneously breathing; no patient was placed on extracorporeal membrane oxygenation. High-flow nasal cannula was used in 51 patients (48.1%). Acute kidney injury was the most common complication, seen in 20 patients (18.9%), and 12 patients (11.3%) required renal replacement therapy. A total of 53 patients (50.0%) received corticosteroids.
Interpretation: Our cohort of critically ill patients with COVID-19 had lower mortality than that previously described in other jurisdictions. These findings may help guide critical care decision-making in similar health care systems in further COVID-19 surges.