1. Severe infection due to the SARS-CoV-2 coronavirus: Experience of a tertiary hospital with COVID-19 patients during the 2020 pandemic.
- Author
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Rodríguez A, Moreno G, Gómez J, Carbonell R, Picó-Plana E, Benavent Bofill C, Sánchez Parrilla R, Trefler S, Esteve Pitarch E, Canadell L, Teixido X, Claverias L, and Bodí M
- Subjects
- Age Distribution, Aged, Anti-Bacterial Agents therapeutic use, Bacterial Infections complications, Bacterial Infections drug therapy, COVID-19 mortality, COVID-19 therapy, Chi-Square Distribution, Contraindications, Procedure, Female, Hospital Mortality, Hospitalization statistics & numerical data, Humans, Intensive Care Units, Male, Middle Aged, Multimorbidity, Noninvasive Ventilation adverse effects, Prospective Studies, Respiration, Artificial methods, Spain epidemiology, Statistics, Nonparametric, Tertiary Care Centers, COVID-19 Drug Treatment, COVID-19 epidemiology, Pandemics, SARS-CoV-2
- Abstract
Objective: To describe the clinical and respiratory characteristics of a cohort of 43 patients with COVID-19 after an evolutive period of 28 days., Design: A prospective, single-center observational study was carried out., Setting: Intensive care., Patients: Patients admitted due to COVID-19 and respiratory failure., Interventions: None., Variables: Automatic recording was made of demographic variables, severity parameters, laboratory data, assisted ventilation (HFO: high-flow oxygen therapy and IMV: invasive mechanical ventilation), oxygenation (PaO
2 , PaO2 /FiO2 ) and complications. The patients were divided into three groups: survivors (G1), deceased (G2) and patients remaining under admission (G3). The chi-squared test or Fisher exact test (categorical variables) was used, along with the Mann-Whitney U-test or Wilcoxon test for analyzing the differences between medians. Statistical significance was considered for p<0.05., Results: A total of 43 patients were included (G1=28 [65.1%]; G2=10 [23.3%] and G3=5 [11.6%]), with a mean age of 65 years (range: 52-72), 62% males, APACHE II 18 (15-24), SOFA 6 (4-7). Arterial hypertension (30.2%) and obesity (25.6%) were the most frequent comorbidities. High-flow oxygen therapy was used in 62.7% of the patients, with failure in 85%. In turn, 95% of the patients required IMV and 85% received ventilation in prone decubitus. In the general population, initial PaO2 /FiO2 improved after 7 days (165 [125-210] vs.194 [153-285]; p=0.02), in the same way as in G1 (164 [125-197] vs. 207 [160-294]; p=0.07), but not in G2 (163 [95-197] vs. 135 [85-177]). No bacterial coinfection was observed. The incidence of IMV-associated pneumonia was high (13 episodes/1000 days of IMV)., Conclusions: Patients with COVID-19 require early IMV, a high frequency of ventilation in prone decubitus, and have a high incidence of failed HFO. The lack of improvement of PaO2 /FiO2 at 7 days could be a prognostic marker. ., (Copyright © 2020 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.)- Published
- 2020
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