Timing and causes of death in severe COVID-19 patients.
Timing and causes of death in severe COVID-19 patients.
复制标题
DOI：
10.1186/s13054-021-03639-w
复制
发表时间：
2021-06-30
期刊：
影响因子：
--
通讯作者：
Llitjos JF
中科院分区：
文献类型：
--
作者：
de Roquetaillade C;Bredin S;Lascarrou JB;Soumagne T;Cojocaru M;Chousterman BG;Leclerc M;Gouhier A;Piton G;Pène F;Stoclin A;Llitjos JF
之前报道严重COVID-19患者死亡原因的研究提供了相互矛盾的结果。本研究的目的是描述重症监护病房（ICU）重症COVID-19患者的死亡原因和死亡时间。我们对法国7家医院的8个icu进行了回顾性研究。所有经pcr确诊的SARS-CoV-2感染并急性呼吸衰竭连续入住ICU的成人患者（年龄≥18岁）均纳入分析。根据医疗记录报告ICU死亡的原因和时间。2020年3月1日至4月28日，287例SARS-CoV-2相关急性呼吸衰竭患者入住ICU。其中ICU死亡93例（32%）。与covid -19相关的多器官功能障碍综合征（MODS）是主要死亡原因（37%）。继发性感染相关MODS占ICU死亡的26%，其中大多数是呼吸机相关肺炎。难治性低氧血症/肺纤维化导致19%的病例死亡。13%的病例发生致死性缺血性事件（静脉或动脉）。入住ICU至死亡的中位时间为15天（第25 ~ 75 IQR， 7 ~ 27天）。与covid -19相关的MODS从入住ICU到死亡的中位时间为14天（第25 - 75 IQR: 7-19天），而入住ICU后的前3天仅发生1例死亡。在我们的多中心观察性研究中，在ICU重症COVID-19患者中，与COVID-19相关的MODS和继发感染是两大死亡原因。
Previous studies reporting the causes of death in patients with severe COVID-19 have provided conflicting results. The objective of this study was to describe the causes and timing of death in patients with severe COVID-19 admitted to the intensive care unit (ICU). We performed a retrospective study in eight ICUs across seven French hospitals. All consecutive adult patients (aged ≥ 18 years) admitted to the ICU with PCR-confirmed SARS-CoV-2 infection and acute respiratory failure were included in the analysis. The causes and timing of ICU deaths were reported based on medical records. From March 1, 2020, to April 28, 287 patients were admitted to the ICU for SARS-CoV-2 related acute respiratory failure. Among them, 93 patients died in the ICU (32%). COVID-19-related multiple organ dysfunction syndrome (MODS) was the leading cause of death (37%). Secondary infection-related MODS accounted for 26% of ICU deaths, with a majority of ventilator-associated pneumonia. Refractory hypoxemia/pulmonary fibrosis was responsible for death in 19% of the cases. Fatal ischemic events (venous or arterial) occurred in 13% of the cases. The median time from ICU admission to death was 15 days (25th–75th IQR, 7–27 days). COVID-19-related MODS had a median time from ICU admission to death of 14 days (25th–75th IQR: 7–19 days), while only one death had occurred during the first 3 days since ICU admission. In our multicenter observational study, COVID-19-related MODS and secondary infections were the two leading causes of death, among severe COVID-19 patients admitted to the ICU.
登录
查看更多内容
DOI：
10.1186/s13054-020-03449-6
发表时间：
2021-01-04
期刊：
Critical care (London, England)
影响因子：
--
作者：
Contou D;Fraissé M;Pajot O;Tirolien JA;Mentec H;Plantefève G
通讯作者：
Plantefève G
DOI：
10.1186/s13054-021-03492-x
发表时间：
2021-02-23
期刊：
Critical care (London, England)
影响因子：
--
作者：
Contou D;Cally R;Sarfati F;Desaint P;Fraissé M;Plantefève G
通讯作者：
Plantefève G
DOI：
10.1086/591708
发表时间：
2008-10-01
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Morens DM;Taubenberger JK;Fauci AS
通讯作者：
Fauci AS
DOI：
10.1016/j.cmi.2020.07.016
发表时间：
2020-12
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Langford BJ;So M;Raybardhan S;Leung V;Westwood D;MacFadden DR;Soucy JR;Daneman N
通讯作者：
Daneman N
影响因子：
38.9
作者：
COVID-ICU Group on behalf of the REVA Network and the COVID-ICU Investigators
通讯作者：
COVID-ICU Group on behalf of the REVA Network and the COVID-ICU Investigators