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Observational Study
. 2020 Sep;48(9):e799-e804.
doi: 10.1097/CCM.0000000000004457.

ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019

Sara C Auld  1   2   3   4   5   6   7   8   9   10   11 , Mark Caridi-Scheible  1   4 , James M Blum  1   4   5   6 , Chad Robichaux  5   6 , Colleen Kraft  7   8 , Jesse T Jacob  3   7 , Craig S Jabaley  1   4 , David Carpenter  1 , Roberta Kaplow  9 , Alfonso C Hernandez-Romieu  7 , Max W Adelman  7 , Greg S Martin  1   2   6 , Craig M Coopersmith  1   10 , David J Murphy  1   2   11 ; and the Emory COVID-19 Quality and Clinical Research Collaborative
Affiliations
Observational Study

ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019

Sara C Auld et al. Crit Care Med. 2020 Sep.

Abstract

Objectives: To determine mortality rates among adults with critical illness from coronavirus disease 2019.

Design: Observational cohort study of patients admitted from March 6, 2020, to April 17, 2020.

Setting: Six coronavirus disease 2019 designated ICUs at three hospitals within an academic health center network in Atlanta, Georgia, United States.

Patients: Adults greater than or equal to 18 years old with confirmed severe acute respiratory syndrome-CoV-2 disease who were admitted to an ICU during the study period.

Interventions: None.

Measurements and main results: Among 217 critically ill patients, mortality for those who required mechanical ventilation was 35.7% (59/165), with 4.8% of patients (8/165) still on the ventilator at the time of this report. Overall mortality to date in this critically ill cohort is 30.9% (67/217) and 60.4% (131/217) patients have survived to hospital discharge. Mortality was significantly associated with older age, lower body mass index, chronic renal disease, higher Sequential Organ Failure Assessment score, lower PaO2/FIO2 ratio, higher D-dimer, higher C-reactive protein, and receipt of mechanical ventilation, vasopressors, renal replacement therapy, or vasodilator therapy.

Conclusions: Despite multiple reports of mortality rates exceeding 50% among critically ill adults with coronavirus disease 2019, particularly among those requiring mechanical ventilation, our early experience indicates that many patients survive their critical illness.

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Conflict of interest statement

Drs. Auld and Blum received support for article research from the National Institutes of Health (NIH). Dr. Blum’s institution received funding from the NIH received funding from Clew Medical. Dr. Jacob received funding from UptoDate. Dr. Martin received funding from Grifols. The remaining authors have disclosed that they do not have any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Flow diagram for study patients who were admitted to a coronavirus disease-ICU (COVID-ICU) (A), and received invasive mechanical ventilation (B). COVID-19 = coronavirus disease 2019.
See this image and copyright information in PMC

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References

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