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Clinical and Epidemiological Characteristics of Patients with COVID-19 Admitted to the Intensive Care Unit: A
Juliana Raimondo E Silva Malzone1, Ana Paula Ribeiro1,2, Tatiane Silva de Souza1
1Health Science Post-Graduate Department, School of Medicine, University Santo Amaro, São Paulo 04829-300, Brazil.
Insights
COVID-19 intensive care unit (ICU) admissions peaked in early 2021, with higher mortality observed in older adults, particularly those requiring mechanical ventilation. Age significantly influenced COVID-19 patient outcomes in the ICU.
Area of Science:
- Critical Care Medicine
- Epidemiology
- Infectious Diseases
Background:
- The COVID-19 pandemic caused severe respiratory and motor impairment in hospitalized patients, with lasting effects.
- Intensive care unit (ICU) admission was common for severe cases requiring mechanical ventilation.
Purpose of the Study:
- To analyze the clinical and epidemiological characteristics of COVID-19 patients admitted to ICUs in 2020-2021.
- To investigate the influence of age groups on COVID-19 patient outcomes in the ICU.
Main Methods:
- Retrospective cohort study using data from "ICUs Brasileiras" (March 2020 - November 2021).
- Analysis included hospital admissions, ICU/hospital days, clinical factors (ventilation, comorbidities, frailty, severity scores), and mortality rates.
Main Results:
- Over 166,000 ICU admissions were evaluated; a hospitalization peak occurred March-May 2021.
- Higher mortality was observed in patients aged 40-80 years, with the >81 group having the highest mortality.
- Mortality in ventilated patients was higher in the >70 age group, with a peak in mechanical ventilation (>7 days) from June-August 2021.
Conclusions:
- Age significantly influenced COVID-19 patient characteristics and outcomes in the ICU.
- Patients over 81 years experienced the highest mortality, while those over 70 on mechanical ventilation also showed increased risk.
- Hospitalization patterns and ventilation duration varied between 2020 and 2021.
Abstract:
In March 2020, COVID-19 was characterized as a pandemic by the World Health Organization. Hospitalized patients affected by COVID-19 presented with severe respiratory and motor impairment, especially those who required intensive treatment and invasive mechanical ventilation, with sequelae that extended after the period of hospitalization. Thus, the aim of the current study was to verify the clinical and epidemiological characteristics of patients with COVID-19 admitted to the Intensive Care Unit in 2020 and 2021, according to age group.
Methods:
A retrospective cohort study. Data were collected through the "ICUs Brasileiras" between March 2020 and November 2021 for severe acute respiratory syndrome (SARS) due to COVID-19. The following were analyzed: the number of hospital admissions, days in the ICU and hospital, clinical aspects (non-invasive or invasive ventilatory support, comorbidities, frailty, SAPS 3 and SOFA severity scales, use of amines and renal support), and ICU and hospital mortality rate.
Results:
A total of 166,966 ICU hospital admissions were evaluated over the evaluated quarters. The main results showed a peak in the number of hospitalizations between March and May 2021, with a higher percentage of males. The peak of ICU admissions for 7 days was between March and May 2021 and 21 days between March and May 2020. In addition, higher deaths were observed in the age groups between 40 and 80 years between 2020 and 2021, with the group above 81 being the age group with the highest mortality. Mortality in the ICU of ventilated patients was higher in the age group above 70 years. Another observation was the predominance of SAPS 3 and the peak of mechanical ventilation for more than 7 days between June and August 2021.
Conclusion:
The clinical and epidemiological characteristics of patients with COVID-19 were influenced by age group, showing higher mortality over 81 years and over 70 years in the ICU supported by mechanical ventilation, maintained for 7 days from June to August 2021. The years 2020 and 2021 also showed differences for patients with COVID-19, with greater hospitalization between March and May 2021, especially in the ICU for 7 days, and between March and May 2020 for the 21-day period.
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