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Observational Study
. 2020 Dec 15;15(12):e0243710.
doi: 10.1371/journal.pone.0243710. eCollection 2020.

Clinical characteristics and outcomes of critically ill patients with COVID-19 admitted to an intensive care unit in London: A prospective observational cohort study

Ross J Thomson  1   2 , Jennifer Hunter  3 , Jonathan Dutton  3 , James Schneider  3 , Maryam Khosravi  1   4 , Alisha Casement  1 , Kulwant Dhadwal  1   3 , Daniel Martin  1   5
Affiliations
Observational Study

Clinical characteristics and outcomes of critically ill patients with COVID-19 admitted to an intensive care unit in London: A prospective observational cohort study

Ross J Thomson et al. PLoS One. .

Abstract

Background: Cohorts of severely ill patients with COVID-19 have been described in several countries around the globe, but to date there have been few published reports from the United Kingdom (UK). Understanding the characteristics of the affected population admitted to intensive care units (ICUs) in the UK is crucial to inform clinical decision making, research and planning for future waves of infection.

Methods: We conducted a prospective observational cohort study of all patients with COVID-19 admitted to a large UK ICU from March to May 2020 with follow-up to June 2020. Data were collected from health records using a standardised template. We used multivariable logistic regression to analyse the factors associated with ICU survival.

Results: Of the 156 patients included, 112 (72%) were male, 89 (57%) were overweight or obese, 68 (44%) were from ethnic minorities, and 89 (57%) were aged over 60 years of age. 136 (87%) received mechanical ventilation, 77 (57% of those intubated) were placed in the prone position and 95 (70% of those intubated) received neuromuscular blockade. 154 (99%) patients required cardiovascular support and 44 (28%) required renal replacement therapy. Of the 130 patients with completed ICU episodes, 38 (29%) died and 92 (71%) were discharged alive from ICU. In multivariable models, age (OR 1.13 [95% CI 1.07-1.21]), obesity (OR 3.06 [95% CI 1.16-8.74]), lowest P/F ratio on the first day of admission (OR 0.82 [95% CI 0.67-0.98]) and PaCO2 (OR 1.52 [95% CI 1.01-2.39]) were independently associated with ICU death.

Conclusions: Age, obesity and severity of respiratory failure were key determinants of survival in this cohort. Multiorgan failure was prevalent. These findings are important for guiding future research and should be taken into consideration during future healthcare planning in the UK.

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Conflict of interest statement

I have read the journal's policy and the authors of this manuscript have the following competing interests: DM has received consultancy and lecture fees from Edwards Lifesciences and Siemens Healthineers; none of the other authors have any conflicts of interest to report. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Comorbidities at hospital admission.
Fig 2
Fig 2. Admissions, discharges, transfers and death over time.
Fig 3
Fig 3. Symptoms at hospital admission.
Fig 4
Fig 4. Survival stratified by age and sex.
See this image and copyright information in PMC

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