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Observational Study
. 2020 Nov 24;8(4):E788-E795.
doi: 10.9778/cmajo.20200159. Print 2020 Oct-Dec.

Outcomes and clinical practice in patients with COVID-19 admitted to the intensive care unit in Montréal, Canada: a descriptive analysis

Stephen Su Yang  1 , Jed Lipes  2 , Sandra Dial  2 , Blair Schwartz  2 , Denny Laporta  2 , Evan Wong  2 , Craig Baldry  2 , Paul Warshawsky  2 , Patricia McMillan  2 , David Hornstein  2 , Michel de Marchie  2 , Dev Jayaraman  2
Affiliations
Observational Study

Outcomes and clinical practice in patients with COVID-19 admitted to the intensive care unit in Montréal, Canada: a descriptive analysis

Stephen Su Yang et al. CMAJ Open. .

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic is responsible for millions of infections worldwide, and a substantial number of these patients will be admitted to the intensive care unit (ICU). Our objective was to describe the characteristics, outcomes and management of critically ill patients with COVID-19 pneumonia at a single designated pandemic centre in Montréal, Canada.

Methods: A descriptive analysis was performed on consecutive critically ill patients with COVID-19 pneumonia admitted to the ICU at the Jewish General Hospital, a designated pandemic centre in Montréal, between Mar. 5 and May 21, 2020. Complete follow-up data corresponding to death or discharge from hospital health records were included to Aug. 4, 2020. We summarized baseline characteristics, management and outcomes, including mortality.

Results: A total of 106 patients were included in this study. Twenty-one patients (19.8%) died during their hospital stay, and the ICU mortality was 17.0% (18/106); all patients were discharged home or died, except for 4 patients (2 awaiting a rehabilitation bed and 2 awaiting long-term care). Twelve of 65 patients (18.5%) requiring mechanical ventilation died. Prone positioning was used in 29 patients (27.4%), including in 10 patients who were spontaneously breathing; no patient was placed on extracorporeal membrane oxygenation. High-flow nasal cannula was used in 51 patients (48.1%). Acute kidney injury was the most common complication, seen in 20 patients (18.9%), and 12 patients (11.3%) required renal replacement therapy. A total of 53 patients (50.0%) received corticosteroids.

Interpretation: Our cohort of critically ill patients with COVID-19 had lower mortality than that previously described in other jurisdictions. These findings may help guide critical care decision-making in similar health care systems in further COVID-19 surges.

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Conflict of interest statement

Competing interests: Paul Warshawsky reports personal fees from Gilead Sciences Canada, outside the submitted work. No other competing interests were declared.

Figures

Figure 1:
Figure 1:
Disposition of 106 patients admitted to the intensive care unit with coronavirus disease 2019 pneumonia, by age.
Figure 2:
Figure 2:
Intubation status of 106 patients admitted to the intensive care unit with coronavirus disease 2019 pneumonia, by age.
Figure 3:
Figure 3:
Daily coronavirus disease 2019 (COVID-19) census. Note: ICU = intensive care unit, JGH = Jewish General Hospital.
See this image and copyright information in PMC

References

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