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Multicenter Study
. 2020 Oct;46(10):1863-1872.
doi: 10.1007/s00134-020-06211-2. Epub 2020 Aug 20.

Clinical characteristics and outcomes of critically ill patients with novel coronavirus infectious disease (COVID-19) in China: a retrospective multicenter study

Jianfeng Xie #  1 , Wenjuan Wu #  2 , Shusheng Li #  3 , Yu Hu #  4 , Ming Hu #  5 , Jinxiu Li #  6 , Yi Yang  1 , Tingrong Huang  7 , Kun Zheng  8 , Yishan Wang  9 , Hanyujie Kang  9 , Yingzi Huang  1 , Li Jiang  10 , Wei Zhang  11 , Ming Zhong  12 , Ling Sang  13 , Xia Zheng  14 , Chun Pan  1 , Ruiqiang Zheng  15 , Xuyan Li  9 , Zhaohui Tong  16 , Haibo Qiu  17 , Bin Du  18
Affiliations
Multicenter Study

Clinical characteristics and outcomes of critically ill patients with novel coronavirus infectious disease (COVID-19) in China: a retrospective multicenter study

Jianfeng Xie et al. Intensive Care Med. 2020 Oct.

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 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; Mortality; Organ failure.

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Conflict of interest statement

We declare no competing interests.

Figures

Fig. 1
Fig. 1
Survival of critically ill patients with COVID-19 admitted to ICU. Dashed lines represent 95% CI
Fig. 2
Fig. 2
Temporal changes in laboratory markers from ICU admission in critically ill patients with COVID-19. Figure shows temporal changes in P/F ratio (a), lymphocytes (b), hs-CRP (c), d-dimer (d), LDH (e), and hsc-TnI (f). Differences between survivors and non-survivors were significant for all time points shown. hs-CRP high-sensitive C-reactive protein, LDH lactate dehydrogenase, hsc-TnI high-sensitivity cardiac troponin I
See this image and copyright information in PMC

Comment in

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