Inpatient Mortality According to Level of Respiratory Support Received for Severe Acute Respiratory Syndrome Coronavirus 2 (Coronavirus Disease 2019) Infection: A Prospective Multicenter Study.

Objectives: To describe patients according to the maximum degree of respiratory support received and report their inpatient mortality due to coronavirus disease 2019.
Design: Analysis of patients in the Coracle registry from February 22, 2020, to April 1, 2020.
Setting: Hospitals in the Piedmont, Lombardy, Tuscany, and Lazio regions of Italy.
Patients: Nine-hundred forty-eight patients hospitalized for coronavirus disease 2019.
Interventions: None.
Measurements and Main Results: Among 948 patients, 122 (12.87%) received invasive ventilation, 637 (67.19%) received supplemental oxygen only, and 189 (19.94%) received no respiratory support. The median (quartile 1-quartile 3) age was 65 years (54-76.59 yr), and there was evidence of differential respiratory treatment by decade of life ( p = 0.0046); patients greater than 80 years old were generally not intubated. There were 606 men (63.9%) in this study, and they were more likely to receive respiratory support than women ( p < 0.0001). The rate of in-hospital death for invasive ventilation recipients was 22.95%, 12.87% for supplemental oxygen recipients, and 7.41% for those who received neither ( p = 0.0004). A sensitivity analysis of the 770 patients less than 80 years old revealed a lower, but similar mortality trend (18.02%, 8.10%, 5.23%; p = 0.0008) among the 14.42%, 65.71%, and 19.87% of patients treated with mechanical ventilation, supplemental oxygen only, or neither. Overall, invasive ventilation recipients who died were significantly older than those who survived (median age: 68.5 yr [60-81.36 yr] vs 62.5 yr [55.52-71 yr]; p = 0.0145).
Conclusions: Among patients hospitalized for coronavirus disease 2019, 13% received mechanical ventilation, which was associated with a mortality rate of 23%.
Competing Interests: Dr. Mojoli received funding from GE Healthcare (fee for lectures), Hamilton Medical (fee for lectures), and Seda Spa (fee for lecture) and disclosed a consultancy agreement between University of Pavia and Hamilton Medical. On behalf of the Coracle registry, for the purpose of this study, no ICU data were retrieved by Drs. Corcione or Palazzo. The remaining authors have disclosed that they do not have any potential conflicts of interest.
(Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)