Critically Ill Patients with Coronavirus Disease 2019 in a Designated ICU: Clinical Features and Predictors for Mortality

• Published in: Risk management and healthcare policy Vol. 13; pp. 833 - 845
• Main Authors: Wang, Zhao-Hua, Shu, Chang, Ran, Xiao, Xie, Cui-Hong, Zhang, Lei
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Ltd 01.01.2020; Dove; Dove Medical Press
• Subjects: Adenoviruses; Anorexia; Blood; Consent; Coronaviruses; COVID-19; critically ill; Data collection; Disease; Dyspnea; Hospitals; Immunoglobulins; Infections; Influenza; Intensive care; Laboratories; Lymphocytes; Medical prognosis; Mortality; Neutrophils; Original Research; Pneumonia; prognostic factor; severe acute respiratory coronavirus 2; Severe acute respiratory syndrome coronavirus 2; Survival analysis; Tumor necrosis factor-TNF; Ventilators; Vital signs; China; mortality; pneumonia; prognostic factor; critically ill; severe acute respiratory coronavirus 2
• ISSN: 1179-1594; 1179-1594
• DOI: 10.2147/RMHP.S263095

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic outbreak with a high mortality. Prognostic factors of critically ill patients with COVID-19 have not been fully elucidated yet. In the present study, 59 patients with COVID-19 from the intensive care unit of the Caidian Branch of Tongji Hospital were enrolled. Epidemiological, demographic, clinical, laboratory, radiological, treatment data, and clinical outcomes were collected. Prognostic factors were statistically defined. Of the 59 patients studied (67.4±11.3 years), 38 patients were male, 51 had underlying diseases, and 41 patients died during admission. Compared with the survivors, the deceased patients were of older age, had more smoking history, severer fatigue, and diarrhea, a higher incidence of multiple organ injuries, more deteriorative lymphopenia and thrombocytopenia, remarkably impaired cellular immune response, and strengthened cytokine release. Age higher than 70 (OR=2.76, 95% CI=1.45-5.23), arrhythmia (OR=4.76, 95% CI=1.59-14.25), and a Sequential Organ Failure Assessment (SOFA) score above 4 (OR=5.16, 95% CI=1.29-20.55) were identified as risk factors for mortality of patients. Critically ill COVID-19 patients aged higher than 70, arrhythmia, or a SOFA score above 4 have a high risk of mortality, and need prior medical intervention.