Clinical characteristics and outcomes of critically ill patients with novel coronavirus infectious disease (COVID-19) in
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Clinical characteristics and outcomes of critically ill patients with novel coronavirus infectious disease (COVID‑19) in China: a retrospective multicenter study Jianfeng Xie1, Wenjuan Wu2, Shusheng Li3, Yu Hu4, Ming Hu5, Jinxiu Li6, Yi Yang1, Tingrong Huang7, Kun Zheng8, Yishan Wang9, Hanyujie Kang9, Yingzi Huang1, Li Jiang10, Wei Zhang11, Ming Zhong12, Ling Sang13, Xia Zheng14, Chun Pan1, Ruiqiang Zheng15, Xuyan Li9, Zhaohui Tong9*, Haibo Qiu1* and Bin Du16* © 2020 Springer-Verlag GmbH Germany, part of Springer Nature
Abstract Purpose: An ongoing outbreak of coronavirus disease 2019 (COVID-19) emerged in Wuhan since December 2019 and spread globally. However, information about critically ill patients with COVID-19 is still limited. We aimed to describe the clinical characteristics and outcomes of critically ill patients with COVID-19 and figure out the risk factors of mortality. Methods: We extracted data retrospectively regarding 733 critically ill adult patients with laboratory-confirmed COVID-19 from 19 hospitals in China through January 1 to February 29, 2020. Demographic data, symptoms, laboratory values, comorbidities, treatments, and clinical outcomes were collected. The primary outcome was 28-day mortality. Data were compared between survivors and non-survivors. Results: Of the 733 patients included in the study, the median (IQR) age was 65 (56–73) years and 256 (34.9%) were female. Among these patients, the median (IQR) APACHE II score was 10 (7 to 14) and 28-day mortality was 53.8%. Respiratory failure was the most common organ failure (597 [81.5%]), followed by shock (20%), thrombocytopenia (18.8%), central nervous system (8.6%) and renal dysfunction (8%). Multivariate Cox regression analysis showed that
*Correspondence: [email protected]; [email protected]; [email protected] 1 Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, Jiangsu, China 9 Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao‑Yang Hospital, Capital Medical University, Beijing 100020, China 16 Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and, Chinese Academy of Medical Sciences, Beijing 100730, China Full author information is available at the end of the article Jianfeng Xie, Wenjuan Wu, Shusheng Li, Yu Hu, Ming Hu and Jinxiu Li contributed equally.
older age, malignancies, high APACHE II score, high d-dimer level, low PaO2/FiO2 level, high creatinine level, high hscTnI level and low albumin level were independent risk factors of 28-day mortality in critically ill patients with COVID-19. Conclusion: In this case series of critically ill patients with COVID-19 who were admitted into the ICU, more than half patients died at day 28. The higher percentage of organ failure in these patients indicated a significant demand for critical care resources. Keywords: COVID-19, Critically ill, Organ failur
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