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ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019

Sara C Auld1,2,3,4,5,6,7,8,9,10,11, Mark Caridi-Scheible1,4, James M Blum1,4,5,6

  • 1Emory Critical Care Center (ECCC), Atlanta, GA.

Critical Care Medicine
|May 27, 2020
PubMed

Insights

This study found that 30.9% of critically ill coronavirus disease 2019 patients died, but 60.4% survived to discharge. Mechanical ventilation was associated with higher mortality, yet many patients still survived.

Area of Science:

  • Critical care medicine
  • Infectious diseases
  • Epidemiology

Background:

  • Coronavirus disease 2019 (COVID-19) has caused a global health crisis, with high mortality rates reported in critically ill patients.
  • Early reports indicated mortality exceeding 50% for severe COVID-19 cases requiring intensive care unit (ICU) admission and mechanical ventilation.

Purpose of the Study:

  • To determine the mortality rates among adults with critical illness due to COVID-19.
  • To identify factors associated with mortality in this patient population.

Main Methods:

  • An observational cohort study was conducted involving 217 adult patients admitted to six ICUs across three hospitals between March 6, 2020, and April 17, 2020.
  • Data collected included patient demographics, clinical characteristics, laboratory values, and treatment interventions.

Main Results:

  • Overall mortality in the cohort was 30.9% (67/217), with 60.4% (131/217) surviving to hospital discharge.
  • Among patients requiring mechanical ventilation, the mortality rate was 35.7% (59/165).
  • Factors significantly associated with mortality included older age, lower BMI, chronic renal disease, higher SOFA score, lower PaO2/FIO2 ratio, elevated D-dimer and C-reactive protein levels, and receipt of mechanical ventilation, vasopressors, renal replacement therapy, or vasodilator therapy.

Conclusions:

  • Despite high reported mortality rates for severe COVID-19, this study's early experience suggests a significant proportion of critically ill patients can survive.
  • Mechanical ventilation, while associated with increased mortality, did not preclude survival for many patients.
  • Identifying and managing risk factors is crucial for improving outcomes in critically ill COVID-19 patients.
Abstract

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