COVID-19 - Characteristics and clinical outcomes of patients admitted to Intensive Care Units


  • Daniela Ovadia — Agenzia Zoe
  • Univadis Medical News
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Patients with laboratory-confirmed COVID-19 admitted to Intensive Care Units (ICUs) in Lombardy Region (Italy) were mainly older men.
  • At least one comorbidity was present in more than 2/3 of the cases.
  • The vast majority of the patients needed respiratory support, invasive mechanical ventilation in most cases.
  • Mortality in ICU was 26%.

Why this matters?

  • The percentage of patients in need of ICU care has varied from 5% to 32% in China, being 9% in Italy up through March 18, 2020.
  • ICU beds and the provision of intensive care are limited in many countries.
  • Knowing the baseline characteristics and outcomes of critically ill patients could help planning efforts to address local outbreaks.

Study design

  • Retrospective case series including 1,591 consecutive patients with laboratory-confirmed COVID-19.
  • Patients referred for ICU admission to Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy, the coordinator center of the COVID-19 Lombardy ICU Network and treated in one of the 72 hospitals from the Network.
  • Final follow-up: March 25, 2020.
  • Demographic and clinical data collected and recorded by the coordinator center during telephone calls by the staff of the Network.
  • Funding: Institutional funding of the Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy.

Key results

  • Patients: median age 63 years, 82% male.
  • 68% of patients had at least 1 comorbidity and 49% had hypertension (data on 1,043 patients).
  • 99% of patients needed respiratory support: 88% mechanical ventilation, 11% non-invasive ventilation (data on 1300 patients).
  • The median positive end-expiratory pressure (PEEP) was not different between younger and older (64 years or older), reaching 14 cm H2O.
  • As of March 25, 2020, 58% were still in the ICU, 16% were discharged from and 26% had died in the ICU (data on 1,581 patients).
  • Mortality was higher in older patients (36% in ≥64 years vs 15% in ≤63 years).

Limitations

  • Retrospective study, with data collected via telephone.
  • Detailed information, such as baseline medication use, not available.
  • Relatively short follow-up.
  • Large amounts of missing data for some outcomes.