scholarly journals Convalescent plasma in Severe/ Critically Ill COVID-19 patients; impact of time and mechanical ventilation

2021 ◽  
Keyword(s):  
Mechanical Ventilation ◽  
Survival Rate ◽  
Ct Scan ◽  
Critically Ill ◽  
Severe Disease ◽  
Multiple Organ ◽  
Arterial Oxygen ◽  
Secondary Outcome ◽  
Blood Oxygen Saturation ◽  
Fraction Of Inspired Oxygen

Background: Convalescent plasma (CP) transfusion is one of the suggested treatments for Coronavirus disease 2019 (COVID-19) especially in critically ill patients. Methods: We investigated the efficacy and safety of CP transfusion in 50 consecutive COVID-19 patients with severe/ critically ill disease. Severe disease was defined as having at least one of the following: shortness of breath, respiratory frequency ≥ 20/min, blood oxygen saturation ≤ 93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio < 300, lung infiltrates > 50% within recent 24-48 hours. Critically ill disease was considered as intensive care unit admission, respiratory failure, septic shock, or multiple organ dysfunction or failure. Primary outcomes included the safety of CP transfusion, 14-day and 30-day survival rate, and change in lung computed tomography (CT) scan score. Several other clinical and laboratory features were evaluated as secondary outcome. Results: Of 50 consecutive patients, 21 were on mechanical ventilation at time of CP transfusion. Totally, 32 patients (64%) survived 30 days after CP transfusion. Survival rate was 74% and 44% in patients who received CP <7 and ≥7 days of admission, respectively. While 92% of patients without mechanical ventilation survived, survival was 29% in patients on mechanical ventilation. CT scan score and some other clinical features were improved. No adverse effects were observed. Conclusion: CP transfusion is a safe and effective treatment in COVID-19 patients with severe/ critically ill disease. The best outcome can be achieved in patients who are not on mechanical ventilation especially early in the disease course.

scholarly journals Non-cardio respiratory monitoring of mechanically ventilated critically ill patients

2019 ◽  
pp. S150-S159
Author(s):  
Chinmaya Kumar Panda ◽  
Habib Mohammad Reazaul Karim ◽  
Subrata Kumar Singha
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Well Being ◽  
Multiple Organ ◽  
Respiratory Monitoring ◽  
Arterial Oxygen ◽  
Mechanically Ventilated

Critically ill patients often require multiple organ supports; respiratory support in terms of mechanical ventilation (MV) is one of the commonest. But, only providing an organ support contributes less to the complete well being of the patients. Moreover, MV itself can affect various physiological systems, metabolic response, and cause side effects. A very close temporal relationship exists between patients, monitoring and management decision too, and therefore, appropriate information from monitoring can lead to better outcomes. The present review is intended to briefly highlight the current opinions and strategies for non cardio-respiratory monitoring in such critically ill patients.Abbreviations: AKI-Acute Kidney Injury; APACHE-Acute Physiology and Chronic Health Evaluation; BPS-Behavioral Pain Scale; CAM-ICU-Confusion Assessment Method for the Intensive Care Unit; CPOT–Critical Care Pain Observation Tool; EVLWI-Extra vascular lung water index; FDA-Food and Drug Administration; ISO-International Organization for Standardization; ICU-Intensive Care Unit; LOS-Length of stay; MODS-Multiple Organ Dysfunction Score; MV-Mechanical Ventilation; PaO2-Partial pressure of arterial oxygen; FiO2-Fraction of inspired oxygen; SAPS-Simplified Acute Physiologic Score; RASS-Richmond Agitation Sedation Scale; SOFA-Sequential Organ Failure Assessment; SAS-Sedation Agitation Scale; UO-Urine outputCitation: Panda CK, Karim HMR, Singha SK. Non-cardio respiratory monitoring of mechanically ventilated critically ill patients. Anaesth Pain & Intensive Care 2018;22 Suppl 1:S150-S159Received: 9 Jul 2018 Reviewed: 1 Oct 2018 Corrected & Accepted: 9 Oct 2018

scholarly journals Characteristics, Treatment, and Outcomes of Patients With Severe or Life-threatening COVID-19 at a Military Treatment Facility—A Descriptive Cohort Study

2021 ◽  
Author(s):  
Brian P Elliott ◽  
Gregory M Buchek ◽  
Matthew T Koroscil
Keyword(s):  
Severe Disease ◽  
Ambient Air ◽  
Active Duty ◽  
Urban Setting ◽  
Arterial Oxygen ◽  
Treatment Facility ◽  
Blood Oxygen Saturation ◽  
Life Threatening ◽  
Military Treatment Facility ◽  
Active Duty Personnel

ABSTRACT Introduction The treatment of severe and life-threatening COVID-19 is a rapidly evolving practice. The purpose of our study was to describe the characteristics and outcomes of patients with severe or life-threatening COVID-19 who present to a Military Treatment Facility (MTF) with an emphasis on addressing institutional adaptations to rapidly changing medical evidence. Materials and Methods A single-center retrospective study conducted on a prospectively maintained cohort. The MTF is a 52-bed hospital within an urban setting. Patients were included in the cohort if they had laboratory-confirmed severe or life-threatening COVID-19 with positive SARS-CoV-2 reverse transcription polymerase chain reaction. Severe disease was defined as dyspnea, respiratory frequency ≥30/min, blood oxygen saturation ≤93% on ambient air, partial pressure of arterial oxygen to fraction of inspired oxygen ratio &lt;300, or lung infiltrates involving &gt;50% of lung fields within 24-48 hours. Life-threatening COVID-19 was defined as respiratory failure, septic shock, or multiple organ dysfunction. The cohort included patients admitted from June 1 through November 13. Data were collected retrospectively via chart review by a resident physician. Results In total, our MTF saw 14 cases of severe or life-threatening COVID-19 from June 1 to November 13. Patients had a median age of 70.5 years, with 7% being active duty personnel, 21% dependents, and 71% retired military members. The median time to dexamethasone, remdesivir, and convalescent plasma administration was 4.7, 6.3, and 11.2 hours, respectively. The 28-day in-hospital mortality was 0%. Conclusions Patients who present to an MTF with severe or life-threatening COVID-19 are largely retirees, with only a small fraction comprising active duty personnel. The institution of order sets and early consultation can help facilitate prompt patient care for COVID-19.

Decisions Made By Critical Care Nurses During Mechanical Ventilation and Weaning in an Australian Intensive Care Unit

2007 ◽  
Vol 16 (5) ◽  
pp. 434-443 ◽  
Author(s):  
Louise Rose ◽  
Sioban Nelson ◽  
Linda Johnston ◽  
Jeffrey J. Presneill
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Intensive Care ◽  
Interdisciplinary Collaboration ◽  
Multiple Organ ◽  
Critical Care Nurses ◽  
Royal Melbourne Hospital ◽  
Adult Intensive Care Unit ◽  
Fraction Of Inspired Oxygen

Background Responsibilities of critical care nurses for management of mechanical ventilation may differ among countries. Organizational interventions, including weaning protocols, may have a variable impact in settings that differ in nursing autonomy and interdisciplinary collaboration. Objective To characterize the role of Australian critical care nurses in the management of mechanical ventilation. Methods A 3-month, prospective cohort study was performed. All clinical decisions related to mechanical ventilation in a 24-bed, combined medical-surgical adult intensive care unit at the Royal Melbourne Hospital, a university-affiliated teaching hospital in Melbourne, Victoria, Australia, were determined. Results Of 474 patients admitted during the 81-day study period, 319 (67%) received mechanical ventilation. Death occurred in 12.5% (40/319) of patients. Median durations of mechanical ventilation and intensive care stay were 0.9 and 1.9 days, respectively. A total of 3986 ventilation and weaning decisions (defined as any adjustment to ventilator settings, including mode change; rate or pressure support adjustment; and titration of tidal volume, positive end-expiratory pressure, or fraction of inspired oxygen) were made. Of these, 2538 decisions (64%) were made by nurses alone, 693 (17%) by medical staff, and 755 (19%) by nurses and staff in collaboration. Decisions made exclusively by nurses were less common for patients with predominantly respiratory disease or multiple organ dysfunction than for other patients. Conclusions In this unit, critical care nurses have high levels of responsibility for, and autonomy in, the management of mechanical ventilation and weaning. Revalidation of protocols for ventilation practices in other clinical contexts may be needed.

scholarly journals Association of Preadmission Statin Use and Mortality in Critically Ill Patients: A Meta-Analysis of Cohort Studies

2021 ◽  
Vol 8 ◽  
Author(s):  
Shao-shuo Yu ◽  
Jian Jin ◽  
Ren-qi Yao ◽  
Bo-li Wang ◽  
Lun-yang Hu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Secondary Outcome ◽  
Newcastle Ottawa Scale ◽  
English Articles ◽  
Statin Use

Background: A large number of studies have been conducted to determine whether there is an association between preadmission statin use and improvement in outcomes following critical illness, but the conclusions are quite inconsistent. Therefore, this meta-analysis aims to include the present relevant PSM researches to examine the association of preadmission use of statins with the mortality of critically ill patients.Methods: The PubMed, Web of Science, Embase electronic databases, and printed resources were searched for English articles published before March 6, 2020 on the association between preadmission statin use and mortality in critically ill patients. The included articles were analyzed in RevMan 5.3. The Newcastle-Ottawa Scale (NOS) was used to conduct quality evaluation, and random/fixed effects modeling was used to calculate the pooled ORs and 95% CIs. We also conducted subgroup analysis by outcome indicators (30-, 90-day, hospital mortality).Results: All six PSM observational studies were assessed as having a low risk of bias according to the NOS. For primary outcome—overall mortality, the pooled OR (preadmission statins use vs. no use) across the six included studies was 0.86 (95% CI, 0.76–0.97; P = 0.02). For secondary outcome—use of mechanical ventilation, the pooled OR was 0.94 (95% CI, 0.91–0.97; P = 0.0005). The corresponding pooled ORs were 0.67 (95% CI, 0.43–1.05; P = 0.08), 0.91 (95% CI, 0.83–1.01; P = 0.07), and 0.86 (95% CI, 0.83–0.89; P &lt; 0.00001) for 30-, 90-day, and hospital mortality, respectively.Conclusions: Preadmission statin use is associated with beneficial outcomes in critical ill patients, indicating a lower short-term mortality, less use of mechanical ventilation, and an improvement in hospital survival. Further high-quality original studies or more scientific methods are needed to draw a definitive conclusion.

scholarly journals Early Diagnosis and Prognostic Value of Acute Kidney Injury in Critically Ill Patients

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 506
Author(s):  
Diana Dobilienė ◽  
Jūratė Masalskienė ◽  
Šarūnas Rudaitis ◽  
Astra Vitkauskienė ◽  
Jurgita Pečiulytė ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Length Of Stay ◽  
Critically Ill ◽  
Kidney Injury ◽  
Multiple Organ ◽  
Critically Ill Children ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
Patient Groups ◽  
The Mean

Background and objectives: In hospitalized children, acute kidney injury (AKI) remains to be a frequent and serious condition, associated with increased patient mortality and morbidity. Identifying early biomarkers of AKI and patient groups at the risk of developing AKI is of crucial importance in current clinical practice. Specific human protein urinary neutrophil gelatinase-associated lipocalin (uNGAL) and interleukin 18 (uIL-18) levels have been reported to peak specifically at the early stages of AKI before a rise in serum creatinine (sCr). Therefore, the aim of our study was to determine changes in uNGAL and uIL-18 levels among critically ill children and to identify the patient groups at the highest risk of developing AKI. Materials and methods: This single-center prospective observational study included 107 critically ill children aged from 1 month to 18 years, who were treated in the Pediatric Intensive Care Unit (PICU) of Lithuanian University of Health Sciences Hospital Kauno Klinikos from 1 December 2013, to 30 November 2016. The patients were divided into two groups: those who did not develop AKI (Group 1) and those who developed AKI (Group 2). Results: A total of 68 (63.6%) boys and 39 (36.4%) girls were enrolled in the study. The mean age of the patients was 101.30 ± 75.90 months. The mean length of stay in PICU and hospital was 7.91 ± 11.07 and 31.29 ± 39.09 days, respectively. A total of 32 (29.9%) children developed AKI. Of them, 29 (90.6%) cases of AKI were documented within the first three days from admission to hospital. In all cases, AKI was caused by diseases of non-renal origin. There was a significant association between the uNGAL level and AKI between Groups 1 and 2 both on day 1 (p = 0.04) and day 3 (p = 0.018). Differences in uNGAL normalized to creatinine in the urine (uCr) (uNGAL/uCr) between the groups on days 1 and 3 were also statistically significant (p = 0.007 and p = 0.015, respectively). uNGAL was found to be a good prognostic marker. No significant associations between uIL-18 or Uil-18/uCr and development of AKI were found. However, the uIL-18 level of >69.24 pg/mL during the first 24 h was associated with an eightfold greater risk of AKI progression (OR = 8.33, 95% CI = 1.39–49.87, p = 0.023). The AUC for uIL-18 was 73.4% with a sensitivity of 62.59% and a specificity of 83.3%. Age of <20 months, Pediatric Index of Mortality 2 (PIM2) score of >2.5% on admission to the PICU, multiple organ dysfunction syndrome with dysfunction of three and more organ systems, PICU length of stay more than three days, and length of mechanical ventilation of >five days were associated with a greater risk of developing AKI. Conclusions: Significant risk factors for AKI were age of <20 months, PIM2 score of >2.5% on admission to the PICU, multiple organ dysfunction syndrome with dysfunction of 3 and more organ systems, PICU length of stay of more than three days, and length of mechanical ventilation of > five days. uNGAL was identified as a good prognostic marker of AKI. On admission to PICU, uNGAL should be measured within the first three days in patients at the risk of developing AKI. The uIL-18 level on the first day was found to be as a biomarker predicting the progression of AKI.

scholarly journals Development of a severity of disease score and classification model by machine learning for hospitalized COVID-19 patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0240200
Author(s):  
Miguel Marcos ◽  
Moncef Belhassen-García ◽  
Antonio Sánchez-Puente ◽  
Jesús Sampedro-Gomez ◽  
Raúl Azibeiro ◽  
...  
Keyword(s):  
Machine Learning ◽  
Mechanical Ventilation ◽  
Disease Progression ◽  
Characteristic Curve ◽  
Severe Disease ◽  
Learning Model ◽  
Classification Model ◽  
Blood Oxygen Saturation ◽  
Severity Of Disease ◽  
Machine Learning Model

Background Efficient and early triage of hospitalized Covid-19 patients to detect those with higher risk of severe disease is essential for appropriate case management. Methods We trained, validated, and externally tested a machine-learning model to early identify patients who will die or require mechanical ventilation during hospitalization from clinical and laboratory features obtained at admission. A development cohort with 918 Covid-19 patients was used for training and internal validation, and 352 patients from another hospital were used for external testing. Performance of the model was evaluated by calculating the area under the receiver-operating-characteristic curve (AUC), sensitivity and specificity. Results A total of 363 of 918 (39.5%) and 128 of 352 (36.4%) Covid-19 patients from the development and external testing cohort, respectively, required mechanical ventilation or died during hospitalization. In the development cohort, the model obtained an AUC of 0.85 (95% confidence interval [CI], 0.82 to 0.87) for predicting severity of disease progression. Variables ranked according to their contribution to the model were the peripheral blood oxygen saturation (SpO2)/fraction of inspired oxygen (FiO2) ratio, age, estimated glomerular filtration rate, procalcitonin, C-reactive protein, updated Charlson comorbidity index and lymphocytes. In the external testing cohort, the model performed an AUC of 0.83 (95% CI, 0.81 to 0.85). This model is deployed in an open source calculator, in which Covid-19 patients at admission are individually stratified as being at high or non-high risk for severe disease progression. Conclusions This machine-learning model, applied at hospital admission, predicts risk of severe disease progression in Covid-19 patients.

scholarly journals Development of a severity of disease score and classification model by machine learning for hospitalized COVID-19 patients

2020 ◽  
Author(s):  
Miguel Marcos ◽  
Moncef Belhassen-Garcia ◽  
Antonio Sanchez- Puente ◽  
Jesus Sampedro-Gomez ◽  
Raul Azibeiro ◽  
...  
Keyword(s):  
Machine Learning ◽  
Mechanical Ventilation ◽  
Disease Progression ◽  
Characteristic Curve ◽  
Severe Disease ◽  
Learning Model ◽  
Classification Model ◽  
Blood Oxygen Saturation ◽  
Severity Of Disease ◽  
Machine Learning Model

BACKGROUND: Efficient and early triage of hospitalized Covid-19 patients to detect those with higher risk of severe disease is essential for appropriate case management. METHODS: We trained, validated, and externally tested a machine-learning model to early identify patients who will die or require mechanical ventilation during hospitalization from clinical and laboratory features obtained at admission. A development cohort with 918 Covid-19 patients was used for training and internal validation, and 352 patients from another hospital were used for external testing. Performance of the model was evaluated by calculating the area under the receiver-operating-characteristic curve (AUC), sensitivity and specificity. RESULTS: A total of 363 of 918 (39.5%) and 128 of 352 (36.4%) Covid-19 patients from the development and external testing cohort, respectively, required mechanical ventilation or died during hospitalization. In the development cohort, the model obtained an AUC of 0.85 (95% confidence interval [CI], 0.82 to 0.87) for predicting severity of disease progression. Variables ranked according to their contribution to the model were the peripheral blood oxygen saturation (SpO2)/fraction of inspired oxygen (FiO2) ratio, age, estimated glomerular filtration rate, procalcitonin, C-reactive protein, updated Charlson comorbidity index and lymphocytes. In the external testing cohort, the model performed an AUC of 0.83 (95% CI, 0.81 to 0.85). This model is deployed in an open source calculator, in which Covid-19 patients at admission are individually stratified as being at high or non-high risk for severe disease progression. CONCLUSIONS: This machine-learning model, applied at hospital admission, predicts risk of severe disease progression in Covid-19 patients.

scholarly journals Mechanical ventilation parameters in critically ill COVID-19 patients: a scoping review

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Giacomo Grasselli ◽  
Emanuele Cattaneo ◽  
Gaetano Florio ◽  
Mariachiara Ippolito ◽  
Alberto Zanella ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critically Ill ◽  
Respiratory System ◽  
Scoping Review ◽  
Respiratory Mechanics ◽  
Neuromuscular Blocking ◽  
Arterial Oxygen ◽  
Icu Admission ◽  
Number Of Patients ◽  
Optimal Setting

Abstract Background The mortality of critically ill patients with COVID-19 is high, particularly among those receiving mechanical ventilation (MV). Despite the high number of patients treated worldwide, data on respiratory mechanics are currently scarce and the optimal setting of MV remains to be defined. This scoping review aims to provide an overview of available data about respiratory mechanics, gas exchange and MV settings in patients admitted to intensive care units (ICUs) for COVID-19-associated acute respiratory failure, and to identify knowledge gaps. Main text PubMed, EMBASE, and MEDLINE databases were searched from inception to October 30, 2020 for studies providing at least one ventilatory parameter collected within 24 h from the ICU admission. The quality of the studies was independently assessed using the Newcastle–Ottawa Quality Assessment Form for Cohort Studies. A total of 26 studies were included for a total of 14,075 patients. At ICU admission, positive end expiratory pressure (PEEP) values ranged from 9 to 16.5 cm of water (cmH2O), suggesting that high levels of PEEP were commonly used for setting MV for these patients. Patients with COVID-19 are severely hypoxemic at ICU admission and show a median ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) ranging from 102 to 198 mmHg. Static respiratory system compliance (Crs) values at ICU admission were highly heterogenous, ranging between 24 and 49 ml/cmH2O. Prone positioning and neuromuscular blocking agents were widely used, ranging from 17 to 81 and 22 to 88%, respectively; both rates were higher than previously reported in patients with “classical” acute respiratory distress syndrome (ARDS). Conclusions Available data show that, in mechanically ventilated patients with COVID-19, respiratory mechanics and MV settings within 24 h from ICU admission are heterogeneous but similar to those reported for “classical” ARDS. However, to date, complete data regarding mechanical properties of respiratory system, optimal setting of MV and the role of rescue treatments for refractory hypoxemia are still lacking in the medical literature.

scholarly journals Association between Conventional Oxygen Therapy and Characteristics and Outcomes of Adult Patients in a Surgical Intensive Care Unit

2021 ◽  
Author(s):  
Lubov Stroh ◽  
Dennis Nurjadi ◽  
Florian Uhle ◽  
Thomas Bruckner ◽  
Markus A. Weigand ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Stay ◽  
Critically Ill ◽  
Oxygen Therapy ◽  
Adult Patients ◽  
Arterial Oxygen ◽  
Secondary Outcome ◽  
Surgical Intensive Care Unit ◽  
Organ Dysfunctions

Abstract Background: Oxygen therapy is often used in emergency departments and intensive care units. The prevention of hypoxia with associated complications remains the main target, but a high-concentrated usual oxygen therapy seems not to be the best strategy. We hypothesize that physiological pressure of arterial oxygen (paO2) reduces mortality, onset of new infections and organ dysfunctions in critically ill patients compared with supraphysiological paO2.Methods: In this retrospective exploratory cohort study we included 112 critically ill adult patients treated in a surgical critical care unit. All patients were assigned to two groups defined a priori based on paO2 mean values measured in the first 24 hours of mechanical ventilation: first group paO2 75-100 mmHg (n=43), second group patients with paO2 > 100mmHg (n=69). Primary outcome was the cumulative survival, defined from the day of admission in the intensive care unit (ICU) until death or end of the hospital stay. Secondary outcome was the incidence of infections and new organ dysfunctions in both groups. Results: The baseline characteristics like age, body mass index (BMI), lactate and severity of disease scores were similar in both groups. A total of 27 of 69 patients (39,1%) in the group paO2 > 100mmHg and 12 of 43 patients (27,9%) in the group paO2 75-100mmHg died during their ICU stay or further hospital stay (p=0.54). There were no statistically significant differences in the incidence of new infections and new organ dysfunctions between the two groups. Positive end expiratory pressure (PEEP) and fraction of inspired oxygen (FiO2) were in the group of patients with paO2 > 100mmHg significantly lower 8,4 mbar vs. 9,5 mbar (p=0.03).Conclusions: There was no significant increase in overall mortality or new onset of infections and organ dysfunctions in critically ill adult ICU patients requiring oxygen therapy with supraphysiological paO2 (> 100 mmHg) compared to patients with physiological paO2 (75-100 mmHg). Further studies are needed to define the optimal paO2 parameter.

scholarly journals Delirium Incidence, Duration and Severity in Critically Ill Patients with COVID-19

2020 ◽  
Vol 3 ◽  
Author(s):  
Jessica Hammes ◽  
Sikandar Khan ◽  
Heidi Lindroth ◽  
Babar Khan
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Respiratory Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prolonged Mechanical Ventilation ◽  
Secondary Outcome ◽  
Care Utilization ◽  
Increased Risk ◽  
Brain Behavior

Background:  COVID-19 is associated with severe respiratory failure and high mortality in critically ill patients.2,4,5 Neurologic manifestations of the disease, including delirium and coma, may also be associated with poor clinical outcomes. Delirium is associated with prolonged mechanical ventilation and mortality.3 this study sought to describe the rates, duration, and severity of delirium in patients admitted to the ICU with COVID-19.  Methods:  A retrospective, observational study was conducted from March 1stto April 27th, 2020, at Indiana University Health Methodist and Eskenazi Health Hospitals. The delirium measurements were extracted in the first 14 days of the ICU stay, using the Richmond Agitation and Sedation Scale (RASS) and the CAM-ICU and CAM-ICU7, for those with a positive COVID-19 diagnosis. The primary outcomes were delirium rates and duration; the secondary outcome was delirium severity. Descriptive statistics and median group comparisons were done using SAS v9.4.  Results:   Of 144 patients in the study, 73.6% experienced delirium and 76.4% experienced delirium or coma. The median delirium or coma duration was 7 days (IQR: 3-10), and the median delirium duration was 5 days (IQR: 2-7). The median CAM-ICU-7 score was 6 (IQR: 2-7) signifying severe delirium. Mechanical ventilation was associated increased risk of developing delirium (OR: 22.65, 95% CL: 5.24-97.82). Mortality was also more likely in patients experiencing delirium: 26.4% compared to 15.8% in patients without delirium.   Conclusion:   Of the 144 patients included, 73.6% experienced delirium lasting on average 5 days: the median delirium score being severe. Mechanical ventilation was also associated with greater odds of developing delirium. Because Covid-19 is associated with high rates of delirium, leading to increased rates of functionality disability, more resources and attention are needed to prevent and manage delirium in patients.1      References  Brummel NE, Jackson JC, Pandharipande PP, et al. Delirium in the ICU and subsequent long-term disability among survivors of mechanical ventilation. Critical Care Medicine. 2014;42(2):369-377.  Grasselli G, Pesenti A, Cecconi M. Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response. JAMA. 2020.   Hayhurst CJ, Pandharipande PP, Hughes CG. Intensive Care Unit Delirium: A Review of Diagnosis, Prevention, and Treatment. Anesthesiology. 2016;125(6):1229-1241.  Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020.  Wu Y, Xu X, Chen Z, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain, behavior, and immunity. 2020:S0889-1591(0820)30357-30353. 

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