1. COVID-19 severe pneumonia: Prospective multicentre study on demands on intensive care capacities
- Author
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Michal Moravec, Tomáš Hyánek, Olga Džupová, Jiří Beneš, Frantisek Mosna, Hynek Bartoš, Zdeňka Krupková, Jan Berousek, Tomáš Tencer, Tomas Vymazal, and Peter Brestovanský
- Subjects
Adult ,Male ,medicine.medical_specialty ,Critical Care ,medicine.medical_treatment ,Population ,law.invention ,law ,Intensive care ,Extracorporeal membrane oxygenation ,Humans ,Medicine ,Hospital Mortality ,Prospective Studies ,Renal replacement therapy ,education ,Aged ,education.field_of_study ,SARS-CoV-2 ,business.industry ,Public Health, Environmental and Occupational Health ,Acute kidney injury ,COVID-19 ,General Medicine ,medicine.disease ,Intensive care unit ,Respiratory failure ,Emergency medicine ,Female ,business ,Kidney disease - Abstract
OBJECTIVES: The aim of the study was to obtain data on demands on the intensive care capacities to treat COVID-19 patients, and to identify predictors for in-hospital mortality. METHODS: The prospective observational multicentre study carried out from 1 March till 30 June 2020 included adult patients with confirmed SARS-CoV-2 infection with respiratory failure requiring ventilatory support or high-flow nasal oxygen therapy (HFNO). RESULTS: Seventy-four patients, 46 males and 28 females, median age 67.5 (Q1-Q3: 56-75) years, were included. Sixty-four patients (86.5%) had comorbidity. Sixty-six patients (89.2%) were mechanically ventilated, four of them received extracorporeal membrane oxygenation therapy. Eight patients (10.8%) were treated with non-invasive ventilation and HFNO only. The median of intensive care unit (ICU) stay was 22.5 days. Eighteen patients (24.3%) needed continuous renal replacement therapy. Thirty patients (40.5%) died. Age and acute kidney injury were identified as independent predictors of in-hospital death, and chronic kidney disease showed trend towards statistical significance for poor outcome. CONCLUSIONS: Sufficient number of intensive care beds, organ support equipment and well-trained staff is a decisive factor in managing the COVID-19 epidemic. The study focused on the needs of intensive care in the COVID-19 patients. Advanced age and acute kidney injury were identified as independent predictors for in-hospital mortality. When compared to clinical course and ICU management of patients with severe community-acquired pneumonia caused by other pathogens, we observed prolonged need for ventilatory support, high rate of progression to acute respiratory distress syndrome and significant mortality in studied population.
- Published
- 2021
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