ONE-YEAR REVIEW OF COVID-19 IN THE ICUS OF PHILADELPHIA AREA HOSPITALS

Abstract

TYPE: Abstract TOPIC: Education, Research, and Quality Improvement PURPOSE: The purpose of this study is to identify different factors associated with trend in mortality in the ICU COVID-19 patients. METHODS: This is a retrospective cohort study of ICU COVID-19 patients admitted over one year at our enterprise. The year was divided into four quarters. Chi-square test, Fisher exact test, Cochran-Mantel-Haenszel method, multinomial logistic regression models, independent sample t-test, Mann-Whitney U test and ANOVA were used. RESULTS: Patients who died were older, had higher prevalence of diabetes. Use of invasive mechanical ventilation, BiPAP and ECMO were associated with higher mortality while high flow nasal cannula, remdesivir and dexamethasone were associated with lower mortality. Length of stay in the ICU and hospital were significantly longer in the patients who died. Mortality was significantly lower in the second quarter of the year compared to first, third and fourth quarters (24% vs. >40 %). CONCLUSIONS: We conclude that mortality of COVID-19 patients in ICU may be associated with the overall ICU burden with other COVID-19 patients at the same time. Although use of HFNC, remdesivir and dexamethasone were found to be associated with increased survival in our study, it did not explain significantly higher mortality in third and fourth quarters of the study period. CLINICAL IMPLICATIONS: Strict measures should be taken to flatten the curve and send critically ill COVID-19 patients to less affected ICUs of the other hospitals of the area. DISCLOSURE: Nothing to declare. KEYWORD: COVID-19