Baseline characteristics and outcomes of patients with COVID-19 admitted to intensive care units in Vancouver, Canada: a case series
Baseline characteristics and outcomes of patients with COVID-19 admitted to intensive care units in Vancouver, Canada: a case series
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DOI：
10.1503/cmaj.200794
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发表时间：
2020-06-29
影响因子：
14.6
通讯作者：
Griesdale, Donald E. G.
中科院分区：
文献类型：
--
作者：
Mitra, Anish R.;Fergusson, Nicholas A.;Griesdale, Donald E. G.
背景：大流行性严重急性呼吸综合征冠状病毒2（SARS-CoV-2）与重症监护病房（ICU）的高死亡率相关。我们旨在描述加拿大2019冠状病毒病（COVID-19）重症患者的临床特征和结局。方法：我们对2020年2月21日至4月14日期间连续入住加拿大不列颠哥伦比亚省温哥华地铁6个ICU之一的实验室确诊SARS-CoV-2感染的重症患者进行了回顾性病例系列研究。通过审查患者病历和电子病历收集人口统计学、管理和结局数据。结果：2020年2月21日至4月14日，117名确诊为COVID-19的患者入住ICU。中位年龄为69岁（四分位距[IQR] 60-75），38例（32.5%）为女性。86例（73.5%）患者至少存在1种合并症。74例（63.2%）患者需要有创机械通气。机械通气的持续时间总体为13.5（IQR 8-22）天，成功从ICU出院的患者为11（IQR 6-16）天。4例患者接受托珠单抗给药，1例患者接受羟氯喹给药。截至2020年5月5日，共有18名（15.4%）患者死亡，12名（10.3%）患者仍在ICU，16名（13.7%）患者从ICU出院但仍在医院，71名（60.7%）患者出院回家。解释：在我们的研究中，入住ICU的COVID-19重症患者的死亡率低于先前发表的研究。这些数据表明，与COVID-19引起的危重疾病相关的预后可能不像以前报道的那么差。
BACKGROUND: Pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with high intensive care unit (ICU) mortality. We aimed to describe the clinical characteristics and outcomes of critically ill patients with coronavirus disease 2019 (COVID-19) in a Canadian setting. METHODS: We conducted a retrospective case series of critically ill patients with laboratory-confirmed SARS-CoV-2 infection consecutively admitted to 1 of 6 ICUs in Metro Vancouver, British Columbia, Canada, between Feb. 21 and Apr. 14, 2020. Demographic, management and outcome data were collected by review of patient charts and electronic medical records. RESULTS: Between Feb. 21 and Apr. 14, 2020, 117 patients were admitted to the ICU with a confirmed diagnosis of COVID-19. The median age was 69 (interquartile range [IQR] 60-75) years, and 38 (32.5%) were female. At least 1 comorbidity was present in 86 (73.5%) patients. Invasive mechanical ventilation was required in 74 (63.2%) patients. The duration of mechanical ventilation was 13.5 (IQR 8-22) days overall and 11 (IQR 6-16) days for patients successfully discharged from the ICU. Tocilizumab was administered to 4 patients and hydroxychloroquine to 1 patient. As of May 5, 2020, a total of 18 (15.4%) patients had died, 12 (10.3%) remained in the ICU, 16 (13.7%) were discharged from the ICU but remained in hospital, and 71 (60.7%) were discharged home. INTERPRETATION: In our setting, mortality in critically ill patients with COVID-19 admitted to the ICU was lower than in previously published studies. These data suggest that the prognosis associated with critical illness due to COVID-19 may not be as poor as previously reported.