Abstract
Objectives: To describe clinical characteristics and management of intensive care units (ICU) patients with laboratory-confirmed COVID-19 and to determine 90-day mortality after ICU admission and associated risk factors. Methods: This observational retrospective study was conducted in six intensive care units (ICUs) in three university hospitals in Marseille, France. Between 10 March and 10 May 2020, all adult patients admitted in ICU with laboratory-confirmed SARS-CoV-2 and respiratory failure were eligible for inclusion. The statistical analysis was focused on the mechanically ventilated patients. The primary outcome was the 90-day mortality after ICU admission. Results: Included in the study were 172 patients with COVID-19 related respiratory failure, 117 of whom (67%) received invasive mechanical ventilation. 90-day mortality of the invasively ventilated patients was 27.4%. Median duration of ventilation and median length of stay in ICU for these patients were 20 (9–33) days and 29 (17–46) days. Mortality increased with the severity of ARDS at ICU admission. After multivariable analysis was carried out, risk factors associated with 90-day mortality were age, elevated Charlson comorbidity index, chronic statins intake and occurrence of an arterial thrombosis. Conclusion: In this cohort, age and number of comorbidities were the main predictors of mortality in invasively ventilated patients. The only modifiable factor associated with mortality in multivariate analysis was arterial thrombosis.
Highlights
Coronavirus disease (COVID-19) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide from China
Between 10 March 2020 and 10 May 2020, 172 patients were admitted in intensive care units (ICU) for a pneumonia with laboratory-confirmed SARS-CoV-2 infection
If we focus on the day-90 outcome, our observation is consistent with the mortality of 31% reported in the European prospective study COVID-ICU [9] where 80% of patients had undergone
Summary
Coronavirus disease (COVID-19) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide from China. It was declared pandemic by World Health Organization in March 2020 [1]. Several publications [3,4,5,6,7,8] have given a consistent description of the critically ill patients with COVID-19. Most have reported a 28-day mortality ranging between 28 and 44% with patients still receiving ICU support at the point of publication. Only two European publications reported a 3-months mortality. The first is the French prospective study COVID-ICU [9], which described a cohort of 4244 patients admitted in ICU with a 90-day mortality of 31%.
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