Abstract
PurposeTo describe clinical characteristics and outcomes of ICU patients with COVID-19 and to investigate differences between survivors and non-survivors.MethodsDemographics, symptoms, laboratory values, comorbidities and outcomes were extracted retrospectively from the medical records of ICU patients with confirmed COVID-19 pneumonia from the Elisabeth-TweeSteden Hospital in Tilburg, the Netherlands from March until June 2020. Primary outcome was 28-day mortality and secondary outcomes were differences between survivors and non-survivors.ResultsBetween March 1 and June 4, 2020, 114 patients with COVID-19 were admitted to the ICU. There were 83 (72.8%) survivors and 31 (27.2%) non-survivors. Non-survivors were significantly older (72.0 years [interquartile range, IQR 67.0-76.0] versus 65.0 years [IQR 58.0-73.0], P = 0.002), had a significantly higher Acute Physiology And Chronic Health Evaluation (APACHE) score (54 [IQR 45-72] versus 43 [IQR 36-53], P < 0.001) and Sequential Organ Failure Assessment (SOFA) score (7 [IQR 4-7] versus 5 [IQR 3-6], P = 004). cTnT values were significantly higher in non-survivors due to more myocarditis (83.9% versus 40.8%, P < 0.001). A multivariate Cox regression model revealed SOFA score (hazard ratio, HR 1.337, 95% CI 1.131-1.582, P = 0.001) to be an independent predictor of 28-day mortality.ConclusionWe demonstrated a 28-day mortality rate of 27.2% in our cohort. These patients were older and presented with a higher severity of illness and more organ failure.
Highlights
In late 2019, the novel coronavirus infectious disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection began to spread in China, causing a global pandemic in the first few months of 2020
Non-survivors were significantly older (72.0 years [interquartile range, IQR 67.0-76.0] versus 65.0 years [IQR 58.0-73.0], P = 0.002), had a significantly higher Acute Physiology And Chronic Health Evaluation (APACHE) score (54 [IQR 45-72] versus 43 [IQR 36-53], P < 0.001) and Sequential Organ Failure Assessment (SOFA) score (7 [IQR 4-7] versus 5 [IQR 3-6], P = 004). cTnT values were significantly higher in non-survivors due to more myocarditis (83.9% versus 40.8%, P < 0.001)
A multivariate Cox regression model revealed SOFA score to be an independent predictor of 28-day mortality
Summary
In late 2019, the novel coronavirus infectious disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection began to spread in China, causing a global pandemic in the first few months of 2020. As of January 18, 2021, 93,805,612 SARS-CoV-2 infections and 2,026,093 COVID19-related deaths had been reported worldwide [1]. The majority of COVID-19 infections progresses mildly, 5%-10% of cases develop severe symptoms, rapidly culminating in respiratory failure and/or multiple organ dysfunction and requiring ICU admission [2]. While investigating 3,988 COVID-19 confirmed patients admitted to the ICU in Lombardy, Italy, Graselli et al found a mortality of 48.8% during ICU admission. Other reports found that the presence of various comorbidities in patients with COVID-19 is significantly associated with mortality [4,5,6,7,8,9]
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