Journal
INTENSIVE CARE MEDICINE
Volume 46, Issue 10, Pages 1863-1872Publisher
SPRINGER
DOI: 10.1007/s00134-020-06211-2
Keywords
COVID-19; Critically ill; Organ failure; Mortality
Categories
Funding
- Key Research and Development Plan of Jiangsu Province [BE2018743, BE2019749]
- Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (CIFMS) from China Academy of Medical Sciences and Peking Union Medical College (CN) [2020-I2M-2-005, 2019-I2M-1-001]
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Purpose An ongoing outbreak of coronavirus disease 2019 (COVID-19) emerged in Wuhan since December 2019 and spread globally. However, information about critically ill patients with COVID-19 is still limited. We aimed to describe the clinical characteristics and outcomes of critically ill patients with COVID-19 and figure out the risk factors of mortality. Methods We extracted data retrospectively regarding 733 critically ill adult patients with laboratory-confirmed COVID-19 from 19 hospitals in China through January 1 to February 29, 2020. Demographic data, symptoms, laboratory values, comorbidities, treatments, and clinical outcomes were collected. The primary outcome was 28-day mortality. Data were compared between survivors and non-survivors. Results Of the 733 patients included in the study, the median (IQR) age was 65 (56-73) years and 256 (34.9%) were female. Among these patients, the median (IQR) APACHE II score was 10 (7 to 14) and 28-day mortality was 53.8%. Respiratory failure was the most common organ failure (597 [81.5%]), followed by shock (20%), thrombocytopenia (18.8%), central nervous system (8.6%) and renal dysfunction (8%). Multivariate Cox regression analysis showed that older age, malignancies, high APACHE II score, highd-dimer level, low PaO2/FiO(2)level, high creatinine level, high hscTnI level and low albumin level were independent risk factors of 28-day mortality in critically ill patients with COVID-19. Conclusion In this case series of critically ill patients with COVID-19 who were admitted into the ICU, more than half patients died at day 28. The higher percentage of organ failure in these patients indicated a significant demand for critical care resources.
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