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Early experience with critically ill patients with COVID-19 in Montreal

Yiorgos Alexandros Cavayas1,2, Alexandre Noël3, Veronique Brunette3

  • 1Service de Soins Intensifs, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de l'île de Montréal, Département de Médecine, Université de Montréal, 5400 Gouin Ouest, Montreal, QC, H4J 1C5, Canada. yiorgos.alexandros.cavayas@umontreal.ca.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|September 16, 2020
PubMed

Insights

Critically ill COVID-19 patients in Montreal had similar characteristics and outcomes to other regions. Increased physiologic dead space suggests pulmonary vascular injury is key to COVID-19 lung damage.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pulmonology

Background:

  • Montreal was a major COVID-19 epicenter in Canada.
  • Regional disparities in COVID-19 incidence and mortality were observed.
  • Understanding local characteristics of critically ill patients is crucial.

Purpose of the Study:

  • To describe local characteristics of critically ill COVID-19 patients in Montreal.
  • To analyze treatments and outcomes of these patients.
  • To compare Montreal's COVID-19 ICU patient data with existing literature.

Main Methods:

  • Retrospective cohort study at a single center (Hôpital du Sacré-Cœur de Montréal).
  • Included consecutive adult patients admitted to the intensive care unit (ICU) with confirmed COVID-19.
  • Data collected between March 20 and May 13, 2020.

Main Results:

  • 75 patients admitted; median age 62 years, high rates of obesity, hypertension, and diabetes.
  • 57% required invasive mechanical ventilation (IMV) for a median of 11 days.
  • Overall hospital mortality was 25%, with 82% mortality in patients aged 80+.

Conclusions:

  • Characteristics and outcomes of critically ill COVID-19 patients in Montreal align with existing literature.
  • An increased physiologic dead space was observed in ventilated patients.
  • Pulmonary vascular injury is hypothesized to be central to COVID-19 lung damage.
Abstract

Keywords:
COVID-19acute respiratory distress syndromeintensive caremechanical ventilation

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