key: cord-301336-rycbeax7
authors: Cao, Jianlei; Hu, Xiaoyong; Cheng, Wenlin; Yu, Lei; Tu, Wen-Jun; Liu, Qiang
title: Clinical features and short-term outcomes of 18 patients with corona virus disease 2019 in intensive care unit
date: 2020-03-02
journal: Intensive Care Med
DOI: 10.1007/s00134-020-05987-7
sha: 
doc_id: 301336
cord_uid: rycbeax7

nan

isolated. Seventeen patients died (discharge mortality, 16.7%; 95% confidence interval [CI], 9.4-23.9%), and eighteen patients were admitted to the ICU with a rate of 17.6% (95% CI, 10.2-25.0%). The reasons for admission included need for mechanical ventilation (N = 6), breathing rate increases/oxygen saturation < 90%/no-compliance with noninvasive ventilator (N = 7), and combined shock and/or organ failure (N = 5). The timeline of SARS-CoV-2 onset in ICU patients is shown in Fig. 1 As shown in the supplementary table 1, the treatment in ICU included the administration of a antiviral therapy (100.0%), the use of antibiotics (100.0%), glucocorticoid therapy (61.1%), oxygen inhalation (61.1%), noninvasive ventilation (11.1%), invasive mechanical ventilation (38.9%), extracorporeal membrane oxygenation (16.7%) and CRRT (22.2%). Furthermore, there were no significant difference in drugs treatment, oxygen inhalation and noninvasive ventilation between ICU group and non-ICU group (P > 0.05 all). ICU patients received more intensive treatment with invasive mechanical ventilation (38.9% vs. 4.8%), extracorporeal membrane oxygenation (16.7% vs. 0%) and CRRT (22.2% vs. 2.4%). They also more likely (See figure on previous page.) Fig. 1 The timeline of SARS-CoV-2 onset in ICU patients. a Timeline of SARS-CoV-2 onset in ICU survivors (N = 12) . b Timeline of SARS-CoV-2 onset in ICU non-survivors (N = 6). The results were presented as number (%). The onset of symptom was defined as day 0. The points represent the median value. ICU, intensive care unit; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; MV, mechanical ventilation; NV, noninvasive ventilation; IMV, invasive mechanical ventilation; EMCO, extracorporeal membrane oxygenation; OI, oxygen inhalation; ACI, acute cardiac injury; AKI, acute kidney injury; ALI, acute liver injury . ICU patients had a higher mortality rate than non-ICU patients (33.3% vs. 13.1%), but this difference was not significant (P = 0.081).

Our results suggest that ICU patients suffer at admission from more comorbidities and develop many complications due to hospitalization. During hospitalization they receive more aggressive treatment, and can result in a similar mortality when compared to non-ICU patients. We found that 17.6% of patients required admission to the ICU and 16.7% died. A previous study including 138 patients with COVID-19 showed that 26% of patients required admission to the ICU and 4.3% died [3] . Another study reported that 23% of patients with COVID-19 required admission to the ICU and 11.0% died [4] . It should be noted that most patients in those two studies were still hospitalized at the time of manuscript submission [3, 4] . Our hospital is one of the major tertiary teaching hospitals and is responsible for the treatment of critically ill patients with COVID-19. Thus, our cohort might represent the more severe COVID-19 patients and the rates of death and ICU admission may be overestimated. A recent large-sample and multicenter study showed that only 5% of the included COVID-19 patients were admitted to ICU and 1.36% succumbed [5] .

Clinical features of patients infected with 2019 novel coronavirus in Wuhan

A novel coronavirus from patients with pneumonia in China

Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan

Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

Clinical characteristics of 2019 novel coronavirus infection in China

We thank all patients included in this study. We are really grateful to all the health workers around the world. Their expertise & humanity are fundamental to stop SARS-COV-2 from spreading further. .

JC and XH contributed equally as the co-author. WJT and QL contributed equally as senior authors. JC and WJT had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. JC, XH, WC, LY, WJT, and QL were involved in concept and design. JC, XH, WC, LY, WJT, and QL contributed to acquisition, analysis, or interpretation of data. JC, XH, WJT, and QL were involved in drafting of the manuscript. JC and LY were involved in critical revision of the manuscript for important intellectual content. JC and WJT contributed to statistical analysis. JC, XH, WC, WJT, and QL were involved in administrative, technical, or material support. JC, XH, and WC contributed to supervision. WJT and QL obtained funding. 

Data available can be obtained from the corresponding author.

None reported.

The study funders/sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Not applicable.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Accepted: 21 February 2020