Intensive Care Resources and 60-Day Survival of Critically-Ill COVID-19 Patients.

60-day survival ards covid-19 icu resources

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
07 Feb 2021
Historique:
entrez: 17 3 2021
pubmed: 18 3 2021
medline: 18 3 2021
Statut: epublish

Résumé

Germany reported sufficient intensive care unit (ICU) resources throughout the first wave of coronavirus disease 2019 (COVID-19). The treatment of critically ill COVID-19 patients without rationing may improve the outcome. We therefore analyzed ICU resources allocated to COVID-19 patients with respiratory failure and their outcomes. Retrospectively, we enrolled severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR)-positive patients with respiratory failure from 03/08/2020 to 04/08/2020 and followed until 05/28/2020 in the university hospital of Freiburg, Germany. In the defined interval, 34 COVID-19 patients were admitted to the ICU with median age of 67±13 (31-86) years. Six of 34 (17.6%) were female. All patients suffered from moderate or severe acute respiratory distress syndrome (ARDS), 91.2% of the patients were intubated and 23.5% required extracorporeal membrane oxygenation (ECMO). Proning was performed in 67.6%, renal replacement therapy (RRT) was required in 35.3%. Ninety-six percent required more than 20 nursing hours per day. Mean ICU stay was 21±19 (1-81) days. Sixty-day survival of critically ill COVID-19 patients was 50.0% (17/34). Causes of death were multi-organ failure (52.9%), refractory ARDS (17.6%) and intracerebral hemorrhage (17.6%). Treatment of critically ill COVID-19 patients is protracted and resource-intense. In a context without resources shortage, 50% of COVID-19 with respiratory failure survived up to 60 days.

Sections du résumé

BACKGROUND BACKGROUND
Germany reported sufficient intensive care unit (ICU) resources throughout the first wave of coronavirus disease 2019 (COVID-19). The treatment of critically ill COVID-19 patients without rationing may improve the outcome. We therefore analyzed ICU resources allocated to COVID-19 patients with respiratory failure and their outcomes.
METHODS METHODS
Retrospectively, we enrolled severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR)-positive patients with respiratory failure from 03/08/2020 to 04/08/2020 and followed until 05/28/2020 in the university hospital of Freiburg, Germany.
RESULTS RESULTS
In the defined interval, 34 COVID-19 patients were admitted to the ICU with median age of 67±13 (31-86) years. Six of 34 (17.6%) were female. All patients suffered from moderate or severe acute respiratory distress syndrome (ARDS), 91.2% of the patients were intubated and 23.5% required extracorporeal membrane oxygenation (ECMO). Proning was performed in 67.6%, renal replacement therapy (RRT) was required in 35.3%. Ninety-six percent required more than 20 nursing hours per day. Mean ICU stay was 21±19 (1-81) days. Sixty-day survival of critically ill COVID-19 patients was 50.0% (17/34). Causes of death were multi-organ failure (52.9%), refractory ARDS (17.6%) and intracerebral hemorrhage (17.6%).
CONCLUSIONS CONCLUSIONS
Treatment of critically ill COVID-19 patients is protracted and resource-intense. In a context without resources shortage, 50% of COVID-19 with respiratory failure survived up to 60 days.

Identifiants

pubmed: 33728167
doi: 10.7759/cureus.13210
pmc: PMC7946605
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e13210

Informations de copyright

Copyright © 2021, Lang et al.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Corinna N Lang (CN)

Department of Cardiology and Angiology I (Heart Center Freiburg University - Bad Krozingen), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.
Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.

Viviane Zotzmann (V)

Department of Cardiology and Angiology I (Heart Center Freiburg University - Bad Krozingen), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.
Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.

Bonaventura Schmid (B)

Department of Emergency Medicine, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.

Michael Berchtold-Herz (M)

Department of Cardiovascular Surgery (Heart Center Freiburg University - Bad Krozingen), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.

Stefan Utzolino (S)

Department of General and Visceral Surgery, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.

Paul Biever (P)

Department of Cardiology and Angiology I (Heart Center Freiburg University - Bad Krozingen), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.
Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.

Daniel Duerschmied (D)

Department of Cardiology and Angiology I (Heart Center Freiburg University - Bad Krozingen), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.
Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.

Christoph Bode (C)

Department of Cardiology and Angiology I (Heart Center Freiburg University - Bad Krozingen), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.
Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.

Tobias Wengenmayer (T)

Department of Cardiology and Angiology I (Heart Center Freiburg University - Bad Krozingen), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.
Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.

Dawid L Staudacher (DL)

Department of Cardiology and Angiology I (Heart Center Freiburg University - Bad Krozingen), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.
Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.

Classifications MeSH