tetano
Editor, Senior Moderator
J Crit Care. 2020 Apr 14;58:29-33. doi: 10.1016/j.jcrc.2020.04.004. [Epub ahead of print]
Clinical presentation and initial management critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Brescia, Italy.
Piva S[SUP]1[/SUP], Filippini M[SUP]2[/SUP], Turla F[SUP]3[/SUP], Cattaneo S[SUP]4[/SUP], Margola A[SUP]5[/SUP], De Fulviis S[SUP]6[/SUP], Nardiello I[SUP]7[/SUP], Beretta A[SUP]8[/SUP], Ferrari L[SUP]9[/SUP], Trotta R[SUP]10[/SUP], Erbici G[SUP]11[/SUP], Foc? E[SUP]12[/SUP], Castelli F[SUP]13[/SUP], Rasulo F[SUP]14[/SUP], Lanspa MJ[SUP]15[/SUP], Latronico N[SUP]16[/SUP].
Author information
Abstract
PURPOSE:
An ongoing pandemic of COVID-19 that started in Hubei, China has resulted in massive strain on the healthcare infrastructure in Lombardy, Italy. The management of these patients is still evolving.
MATERIALS AND METHODS:
This is a single-center observational cohort study of critically ill patients infected with COVID-19. Bedside clinicians abstracted daily patient data on history, treatment, and short-term course. We describe management and a proposed severity scale for treatment used in this hospital.
RESULTS:
44 patients were enrolled; with incomplete information on 11. Of the 33 studied patients, 91% were male, median age 64; 88% were overweight or obese. 45% were hypertensive, 12% had been taking an ACE-inhibitor. Noninvasive ventilation was performed on 39% of patients for part or all or their ICU stay with no provider infection. Most patients received antibiotics for pneumonia. Patients also received lopinivir/ritonavir (82%), hydroxychloroquine (79%), and tocilizumab (12%) according to this treatment algorithm. Nine of 10 patients survived their ICU course and were transferred to the floor, with one dying in the ICU.
CONCLUSIONS:
ICU patients with COVID-19 frequently have hypertension. Many could be managed with noninvasive ventilation, despite the risk of aerosolization. The use of a severity scale augmented clinician management.
Copyright ? 2020 The Authors. Published by Elsevier Inc. All rights reserved.
KEYWORDS:
COVID-19; Novel coronavirus; SARS-CoV-2
PMID:32330817DOI:10.1016/j.jcrc.2020.04.004
Clinical presentation and initial management critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Brescia, Italy.
Piva S[SUP]1[/SUP], Filippini M[SUP]2[/SUP], Turla F[SUP]3[/SUP], Cattaneo S[SUP]4[/SUP], Margola A[SUP]5[/SUP], De Fulviis S[SUP]6[/SUP], Nardiello I[SUP]7[/SUP], Beretta A[SUP]8[/SUP], Ferrari L[SUP]9[/SUP], Trotta R[SUP]10[/SUP], Erbici G[SUP]11[/SUP], Foc? E[SUP]12[/SUP], Castelli F[SUP]13[/SUP], Rasulo F[SUP]14[/SUP], Lanspa MJ[SUP]15[/SUP], Latronico N[SUP]16[/SUP].
Author information
Abstract
PURPOSE:
An ongoing pandemic of COVID-19 that started in Hubei, China has resulted in massive strain on the healthcare infrastructure in Lombardy, Italy. The management of these patients is still evolving.
MATERIALS AND METHODS:
This is a single-center observational cohort study of critically ill patients infected with COVID-19. Bedside clinicians abstracted daily patient data on history, treatment, and short-term course. We describe management and a proposed severity scale for treatment used in this hospital.
RESULTS:
44 patients were enrolled; with incomplete information on 11. Of the 33 studied patients, 91% were male, median age 64; 88% were overweight or obese. 45% were hypertensive, 12% had been taking an ACE-inhibitor. Noninvasive ventilation was performed on 39% of patients for part or all or their ICU stay with no provider infection. Most patients received antibiotics for pneumonia. Patients also received lopinivir/ritonavir (82%), hydroxychloroquine (79%), and tocilizumab (12%) according to this treatment algorithm. Nine of 10 patients survived their ICU course and were transferred to the floor, with one dying in the ICU.
CONCLUSIONS:
ICU patients with COVID-19 frequently have hypertension. Many could be managed with noninvasive ventilation, despite the risk of aerosolization. The use of a severity scale augmented clinician management.
Copyright ? 2020 The Authors. Published by Elsevier Inc. All rights reserved.
KEYWORDS:
COVID-19; Novel coronavirus; SARS-CoV-2
PMID:32330817DOI:10.1016/j.jcrc.2020.04.004