tetano
Editor, Senior Moderator
Med Intensiva
. 2020 Jul 11;S0210-5691(20)30245-X.
doi: 10.1016/j.medin.2020.06.015. Online ahead of print.
Acute respiratory distress syndrome due to COVID-19. Clinical and prognostic features from a medical Critical Care Unit in Valencia, Spain
[Article in En, Spanish]
P Ram?rez[SUP] 1 [/SUP], M Gord?n[SUP] 2 [/SUP], M Mart?n-Cerezuela[SUP] 2 [/SUP], E Villarreal[SUP] 2 [/SUP], E Sancho[SUP] 2 [/SUP], M Padr?s[SUP] 2 [/SUP], J Frasquet[SUP] 3 [/SUP], G Leyva[SUP] 2 [/SUP], I Molina[SUP] 2 [/SUP], M Barrios[SUP] 2 [/SUP], S Gimeno[SUP] 2 [/SUP], ? Castellanos[SUP] 2 [/SUP]
Affiliations
Abstract
Objective: Information from critically ill coronavirus disease 2019 (COVID-19) patients is limited and in many cases coming from health systems approaches different from the national public systems existing in most countries in Europe. Besides, patient follow-up remains incomplete in many publications. Our aim is to characterize acute respiratory distress syndrome (ARDS) patients admitted to a medical critical care unit (MCCU) in a referral hospital in Spain.
Design: Retrospective case series of consecutive ARDS COVID-19 patients admitted and treated in our MCCU.
Setting: 36-bed MCCU in referral tertiary hospital.
Patients and participants: SARS-CoV-2 infection confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay of nasal/pharyngeal swabs.
Interventions: None MAIN VARIABLES OF INTEREST: Demographic and clinical data were collected, including data on clinical management, respiratory failure, and patient mortality.
Results: Forty-four ARDS COVID-19 patients were included in the study. Median age was 61.50 (53.25 - 67) years and most of the patients were male (72.7%). Hypertension and dyslipidemia were the most frequent co-morbidities (52.3 and 36.4% respectively). Steroids (1mg/Kg/day) and tocilizumab were administered in almost all patients (95.5%). 77.3% of the patients needed invasive mechanical ventilation for a median of 16 days [11-28]. Prone position ventilation was performed in 33 patients (97%) for a median of 3 sessions [2-5] per patient. Nosocomial infection was diagnosed in 13 patients (29.5%). Tracheostomy was performed in ten patients (29.4%). At study closing all patients had been discharged from the CCU and only two (4.5%) remained in hospital ward. MCCU length of stay was 18 days [10-27]. Mortality at study closing was 20.5% (n 9); 26.5% among ventilated patients.
Conclusions: The seven-week period in which our MCCU was exclusively dedicated to COVID-19 patients has been challenging. Despite the severity of the patients and the high need for invasive mechanical ventilation, mortality was 20.5%.
Keywords: ARDS; COVID-19; Critical care; Cuidados cr?ticos; Neumon?a viral; SARS-CoV-2; SDRA; Viral pneumonia.
. 2020 Jul 11;S0210-5691(20)30245-X.
doi: 10.1016/j.medin.2020.06.015. Online ahead of print.
Acute respiratory distress syndrome due to COVID-19. Clinical and prognostic features from a medical Critical Care Unit in Valencia, Spain
[Article in En, Spanish]
P Ram?rez[SUP] 1 [/SUP], M Gord?n[SUP] 2 [/SUP], M Mart?n-Cerezuela[SUP] 2 [/SUP], E Villarreal[SUP] 2 [/SUP], E Sancho[SUP] 2 [/SUP], M Padr?s[SUP] 2 [/SUP], J Frasquet[SUP] 3 [/SUP], G Leyva[SUP] 2 [/SUP], I Molina[SUP] 2 [/SUP], M Barrios[SUP] 2 [/SUP], S Gimeno[SUP] 2 [/SUP], ? Castellanos[SUP] 2 [/SUP]
Affiliations
- PMID: 32919796
- DOI: 10.1016/j.medin.2020.06.015
Abstract
Objective: Information from critically ill coronavirus disease 2019 (COVID-19) patients is limited and in many cases coming from health systems approaches different from the national public systems existing in most countries in Europe. Besides, patient follow-up remains incomplete in many publications. Our aim is to characterize acute respiratory distress syndrome (ARDS) patients admitted to a medical critical care unit (MCCU) in a referral hospital in Spain.
Design: Retrospective case series of consecutive ARDS COVID-19 patients admitted and treated in our MCCU.
Setting: 36-bed MCCU in referral tertiary hospital.
Patients and participants: SARS-CoV-2 infection confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay of nasal/pharyngeal swabs.
Interventions: None MAIN VARIABLES OF INTEREST: Demographic and clinical data were collected, including data on clinical management, respiratory failure, and patient mortality.
Results: Forty-four ARDS COVID-19 patients were included in the study. Median age was 61.50 (53.25 - 67) years and most of the patients were male (72.7%). Hypertension and dyslipidemia were the most frequent co-morbidities (52.3 and 36.4% respectively). Steroids (1mg/Kg/day) and tocilizumab were administered in almost all patients (95.5%). 77.3% of the patients needed invasive mechanical ventilation for a median of 16 days [11-28]. Prone position ventilation was performed in 33 patients (97%) for a median of 3 sessions [2-5] per patient. Nosocomial infection was diagnosed in 13 patients (29.5%). Tracheostomy was performed in ten patients (29.4%). At study closing all patients had been discharged from the CCU and only two (4.5%) remained in hospital ward. MCCU length of stay was 18 days [10-27]. Mortality at study closing was 20.5% (n 9); 26.5% among ventilated patients.
Conclusions: The seven-week period in which our MCCU was exclusively dedicated to COVID-19 patients has been challenging. Despite the severity of the patients and the high need for invasive mechanical ventilation, mortality was 20.5%.
Keywords: ARDS; COVID-19; Critical care; Cuidados cr?ticos; Neumon?a viral; SARS-CoV-2; SDRA; Viral pneumonia.