Improved outcomes over time for adult COVID-19 patients with acute respiratory distress syndrome or acute respiratory failure

• Published in: PloS one Vol. 16; no. 6; p. e0253767
• Main Authors: Yeates, Eric O, Nahmias, Jeffry, Chinn, Justine, Sullivan, Brittany, Stopenski, Stephen, Amin, Alpesh N, Nguyen, Ninh T
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 25.06.2021; Public Library of Science (PLoS)
• Subjects: Adults; Biology and Life Sciences; Coronaviruses; COVID-19; Demographics; Demography; Diabetes; Health care facilities; Hospitals; Hypertension; Intubation; Length of stay; Long term health care; Mechanical ventilation; Medicine and Health Sciences; Mortality; Oxygen; Oxygen requirement; Oxygen requirements; Oxygenation; Pandemics; Patient positioning; Patients; Research and Analysis Methods; Respiratory distress syndrome; Respiratory failure; Severe acute respiratory syndrome coronavirus 2; Supervision; Surgery; Trends; Ventilation; Ventilators; United States; United States > US; California
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0253767

COVID-19's pulmonary manifestations are broad, ranging from pneumonia with no supplemental oxygen requirements to acute respiratory distress syndrome (ARDS) with acute respiratory failure (ARF). In response, new oxygenation strategies and therapeutics have been developed, but their large-scale effects on outcomes in severe COVID-19 patients remain unknown. Therefore, we aimed to examine the trends in mortality, mechanical ventilation, and cost over the first six months of the pandemic for adult COVID-19 patients in the US who developed ARDS or ARF. The Vizient Clinical Data Base, a national database comprised of administrative, clinical, and financial data from academic medical centers, was queried for patients [greater than or equal to] 18-years-old with COVID-19 and either ARDS or ARF admitted between 3/2020-8/2020. Demographics, mechanical ventilation, length of stay, total cost, mortality, and discharge status were collected. Mann-Kendall tests were used to assess for significant monotonic trends in total cost, mechanical ventilation, and mortality over time. Chi-square tests were used to compare mortality rates between March-May and June-August. This study describes the outcomes of a large cohort with COVID-19 ARDS or ARF and the subsequent decrease in cost, mechanical ventilation, and mortality over the first 6 months of the pandemic in the US.