Initial experiences from patients with COVID-19 on ventilatory support in Denmark

Area of Science:

• Intensive Care Medicine
• Infectious Diseases
• Respiratory Medicine

Background:

• The COVID-19 pandemic impacted Denmark starting in early 2020.
• Roskilde Hospital served as a primary ICU referral center for COVID-19 patients in the Zealand Region.
• Initial ICU experiences with critically ill COVID-19 patients are presented.

Purpose of the Study:

• To evaluate the initial intensive care unit (ICU) experiences with COVID-19 patients.
• To characterize the clinical presentation and treatment requirements of COVID-19 patients with respiratory failure.
• To identify key themes and challenges in managing severe COVID-19 cases in the ICU.

Main Methods:

• Retrospective evaluation of COVID-19 patients admitted to the ICU for respiratory failure between March 11 and April 1, 2020.
• Assessment of ICU bed capacity expansion from 8 to 22 beds during the study period.
• Analysis of patient demographics, respiratory support needs, laboratory findings, and outcomes.

Main Results:

• Sixteen patients (median age 69.5 years) were evaluated, all requiring mechanical ventilation for hypoxemic respiratory failure.
• Key findings included elevated C-reactive protein, high inspiratory oxygen fraction requirements, and significant positive end-expiratory pressure (PEEP) dependency.
• Patients experienced prolonged ICU stays (average 14 ± 9 days) and fluctuating respiratory failure compared to non-COVID-19 patients.

Conclusions:

• COVID-19 patients exhibit characteristic laboratory findings and present significant challenges due to illness severity.
• Prolonged ventilatory support and high PEEP requirements are critical aspects of managing these patients.
• Effective management strategies are essential for addressing the complex treatment needs of severe COVID-19 cases.