scholarly journals Clinical Features and Prognosis of Invasive Ventilation in Hospitalized Patients with COVID-19: A Retrospective Study

2020 ◽  
Vol 10 (6) ◽  
Author(s):  
Poupak Rahimzadeh ◽  
Hamid Reza Faiz ◽  
Reza Farahmandrad ◽  
Babak Hassanlouei ◽  
Azadeh Habibi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Respiratory Rate ◽  
Critically Ill ◽  
Clinical Features ◽  
Critically Ill Patients ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
World Health ◽  
The Mean ◽  
Lung Ct

Background: World Health Organization (WHO) declared that the outbreak of COVID-19 constituted a public health emergency of global concern. Objectives: Owing to limited data on critically ill patients admitted to ICU, we aimed to describe the clinical characteristics and prognosis of these patients based on ventilatory variables and clinical features. Methods: In this retrospective study, 45 critically ill patients with laboratory-confirmed COVID-19 who were admitted to Intensive Care Unit (ICU) wards of the hospital from April 8 to May 9, 2020, were enrolled. Medical files of the patients were reviewed, and demographic and clinical characteristics, laboratory data, lung CT scan findings, causes of intubation, and outcomes of the patients were all collected. Results: The median age of the patients was 67 years (range 22 to 91), 64% were men, and hypertension was the most common comorbidity. History of close contact with previously confirmed patients was positive in 62.2% of the patients. The mean time from symptom onset to hospital admission was 5.98 ± 2.93 days. The most common symptoms at the onset of illness were dyspnea (95.6%), and gastrointestinal symptoms (22.2%) were rare. The average length of the intubation was 4.84 ± 3.28 days. The distribution of intubation causes in the deceased patients was significantly more than the recovered patients (P = 0.031). The mean score of lung CT involvement in deaths (370.26 ± 207.50) was significantly higher than the recovered patients (235.71 ± 81.21) (P = 0.042). Length of the intubation had a statistically direct correlation with respiratory rate (P = 0.03). Conclusions: Most of the critically ill patients admitted to ICU were older men and had poor outcomes with a high mortality rate. Furthermore, the score of chest CT involvement and respiratory rate are important prognostic factors in determining the severity of the illness, requiring ventilatory support, and outcome.

scholarly journals Critically Ill vs. Non-Critically Ill Patients With COVID-19 Pneumonia: Clinical Features, Laboratory Findings, and Prediction

2021 ◽  
Vol 11 ◽  
Author(s):  
Wandong Hong ◽  
Qin Chen ◽  
Songzan Qian ◽  
Zarrin Basharat ◽  
Vincent Zimmer ◽  
...  
Keyword(s):  
Critical Illness ◽  
Disease Severity ◽  
Critically Ill ◽  
Clinical Features ◽  
Critically Ill Patients ◽  
Interleukin 6 ◽  
Discharge Rate ◽  
Laboratory Data ◽  
Laboratory Findings ◽  
Laboratory Parameters

ObjectivesThe objective of this study was to investigate the clinical features and laboratory findings of patients with and without critical COVID-19 pneumonia and identify predictors for the critical form of the disease.MethodsDemographic, clinical, and laboratory data of 63 COVID-19 pneumonia patients were retrospectively reviewed. Laboratory parameters were also collected within 3–5 days, 7–9 days, and 11–14 days of hospitalization. Outcomes were followed up until March 12, 2020.ResultsTwenty-two patients developed critically ill pneumonia; one of them died. Upon admission, older patients with critical illness were more likely to report cough and dyspnoea with higher respiration rates and had a greater possibility of abnormal laboratory parameters than patients without critical illness. When compared with the non-critically ill patients, patients with serious illness had a lower discharge rate and longer hospital stays, with a trend towards higher mortality. The interleukin-6 level in patients upon hospital admission was important in predicting disease severity and was associated with the length of hospitalization.ConclusionsMany differences in clinical features and laboratory findings were observed between patients exhibiting non-critically ill and critically ill COVID-19 pneumonia. Non-critically ill COVID-19 pneumonia also needs aggressive treatments. Interleukin-6 was a superior predictor of disease severity.

scholarly journals Clinical characteristics and risk factors for severe-critically ill COVID-19 adult patients in Jiangsu, China: a multiple-centered, retrospective study

2020 ◽  
Author(s):  
Jiangnan Zhao ◽  
Meiying Zhu ◽  
Xin Su ◽  
Mao Huang ◽  
Yi Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Characteristics ◽  
Final Analysis ◽  
Adult Patients ◽  
Potential Risk Factors ◽  
Critically Illness ◽  
D Dimer

Abstract Background A number of reports have documented the clinical characteristics of patients with severe coronavirus disease 2019 (COVID-19) in Wuhan. Clinical features of severe-critically ill COVID-19 patients in Jiangsu, outside Wuhan, remains unknown. Methods This multi-centered retrospective study collected the information of 631 laboratory-confirmed COVID-19 patients hospitalized at 28 authorized hospitals in Jiangsu province between January 23, 2019 and March 13, 2020. Epidemiological and demographic information, clinical and radiological characteristics, laboratory results and treatment of these patients were analyzed. Results A total of 583 adult patients with laboratory-confirmed COVID-19 were enrolled for final analysis, including 84 severe-critically ill patients and 499 mild-moderate patients. Median age of the severe-critically ill patients was 57.0 years [interquartile range (IQR), 49.0-65.8], and 50 (59.5%) were males. Multisystemic laboratory abnormalities were observed on admission in severe-critically ill patients. The severe-critically ill patients showed more noticeable radiologic abnormalities and more coexisting health issues as compared to mild-moderate patients. Most of the severe-critically ill COVID-19 patients become deteriorated in two weeks after diagnosis. Age [odds ratio (OR) 1.08, 95% confidence interval (CI) (1.03-1.14)], D-dimer (OR 3.21, 95% CI 1.39-7.40), and lymphocytes (OR 0.28, 95% CI 0.04-0.88) were independently associated with the progression of severe-critically illness. Conclusions Older age, higher D-dimer levels and less lymphocyte counts on admission are potential risk factors for COVID-19 patients to develop into severe and critically illness. The results would help clinicians to identify high-risk patients in advance.

scholarly journals Clinical Characteristics of Critically Ill Patients Infected with COVID-19 in Rasoul Akram Hospital in Iran: A Single Center Study

2020 ◽  
Vol 10 (5) ◽  
Author(s):  
Poupak Rahimzadeh ◽  
Saied Amniati ◽  
Reza Farahmandrad ◽  
Seyed Hamid Reza Faiz ◽  
Setareh Hedayati Emami ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Case Series ◽  
Signs And Symptoms ◽  
Number Of Patients ◽  
Single Center Study ◽  
Very High

Background: Knowledge about clinical features of critically ill patients with COVID-19 still lacks adequate information up to now. Objectives: We aimed to describe and compare the epidemiological and clinical characteristics of critically ill patients with COVID-19 in Rasoul Akram Hospital. Methods: In this case series, 70 critically ill patients with COVID-19 admitted in ICU wards of Rasoul Akram Hospital, Tehran, Iran, from 29 February to 25 April 2020 were enrolled. Demographic and clinical characteristics, laboratory data, and outcomes of the patients were all collected and compared between deceased and recovered patients. Results: Fifty-six cases had died of COVID-19, and 14 patients had fully recovered and discharged. The median age of the patients was 68 years old, ranging from 22 to 91 years, 66% were men, 80% had one or more comorbidities, and hypertension was the most common comorbidities (45% of deceased cases). The most common signs and symptoms at the onset of illness were SPO2 depression (92%) and dyspnea (90%). Dyspnea was significantly more common in deceased patients (95%) than recovered patients (70%) (P = 0.048). Most patients had lymphopenia (80%). The number of patients who needed mechanical ventilation in the deceased patients was 53 (95%), which was significantly more than the recovered patients (10 [70%]) (P = 0.048). Conclusions: The mortality rate of critically ill patients with COVID-19 is very high, and the patients with dyspnea and required mechanical ventilation are at higher risk for death.

scholarly journals Clinical Characteristics and Outcome of Critically Ill SARS-CoV-2 Patients Admitted to Intensive Care Unit of a Tertiary Care Hospital in North India: A Retrospective Study

2021 ◽  
Author(s):  
Reetu Verma ◽  
Rajeev Kumar Nishad ◽  
Rohit Patawa ◽  
Alok Kumar
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Retrospective Study ◽  
Critically Ill ◽  
Clinical Characteristics ◽  
Invasive Mechanical Ventilation ◽  
Age Groups ◽  
World Health ◽  
Comorbid Conditions

Introduction: World Health Organisation (WHO) declared the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outbreak a pandemic on 11 March 2020, due to the constantly increasing number of cases outside China. Previously, India had global record of highest single day spike of Corona Virus Disease-19 (COVID-19) cases, with 97,894 cases on 17thSeptember 2020. Aim: To find out the demographic and clinical characteristics of critically ill patients of SARS-CoV-2 and comparing the outcomes of patients admitted in COVID dedicated Intensive Care Unit (ICU) with and without co-morbidities and also in different age groups and sex. Material and Methods: This retrospective study from July 2020 to December 2020 was a single centre observational experience of management of COVID-19 patients at COVID dedicated ICU in Firozabad, India. The following data were recorded: age, sex, comorbidities and mode of oxygen delivery (invasive mechanical ventilation, non-invasive mechanical ventilation, high flow nasal canula). Chi-square test was used to compare the outcomes of patients admitted in COVID dedicated ICU with and without co-morbidities and also in different age groups and sex. Results: In this study, the data of 120 severely ill COVID-19 patients were reviewed. The mean age of patients were (58±15.29) years and male to female ratio was 3:1. At least one comorbid condition was reported in 53.3% of patients-most common being Hypertension (36.6%) followed by Diabetes mellitus 2 (20%), COPD (15%). Then Cardiovascular Diseases, Renal, Liver diseases and ailments followed. All patients admitted to COVID ICU had moderate to severe Acute Respiratory Distress Syndrome (ARDS). Older age (61 years and above, mortality 17%), male sex (16.7% deaths among 90 critically ill male COVID patients) and presence of comorbid conditions appear to have higher mortality in this study. However apart from comorbid conditions (p=0.001) none was statistically significant. The overall mortality in this study of 120 critically ill COVID patients was 14.16%. Conclusion: From this study, it can be suggested that survival of critically ill COVID patients can further be improved by better management of their comorbid conditions and avoiding complications of invasive ventilation. However, further multicentric studies with large sample size are needed to confirm these findings.

scholarly journals Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sunny Singhal ◽  
Pramod Kumar ◽  
Sumitabh Singh ◽  
Srishti Saha ◽  
Aparajit Ballav Dey
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Critically Ill ◽  
Clinical Features ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Severe Infection ◽  
Factors Affecting ◽  
Pooled Prevalence

Abstract Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients. Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥ 60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support. Result Forty-six studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI– 36-65%, I2–95%) patients while 22% (95% CI– 16-28%, I2–88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2–98%) patients died. The common comorbidities were hypertension (48, 95% CI– 36-60% I2–92%), diabetes mellitus (22, 95% CI– 13-32%, I2–86%) and cardiovascular disease (19, 95% CI – 11-28%, I2–85%). Common symptoms were fever (83, 95% CI– 66-97%, I2–91%), cough (60, 95% CI– 50-70%, I2–71%) and dyspnoea (42, 95% CI– 19-67%, I2–94%). Overall, 84% (95% CI– 60-100%, I2–81%) required oxygen support and 21% (95% CI– 0-49%, I2–91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes. Conclusion Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high-quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.

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