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Observational Study
. 2021 Jan 11;18(5):1198-1206.
doi: 10.7150/ijms.50039. eCollection 2021.

Risk factors for mortality of critically ill patients with COVID-19 receiving invasive ventilation

Ye Tu  1 , Ping Yang  1 , Yaqun Zhou  1 , Xiaoyan Wen  2 , Qinqin Li  1 , Jing Zhou  1 , Jingjing Wang  1 , Jinqian Hu  1 , Nannan He  1 , Kai Wang  3 , Chaolong Wang  3 , Xuebi Tian  1 , Ailin Luo  1 , Feng Gao  1
Affiliations
Observational Study

Risk factors for mortality of critically ill patients with COVID-19 receiving invasive ventilation

Ye Tu et al. Int J Med Sci. .

Abstract

Rationale: Early invasive ventilation may improve outcomes for critically ill patients with COVID-19. The objective of this study is to explore risk factors for 28-day mortality of COVID-19 patients receiving invasive ventilation. Methods: 74 consecutive adult invasively ventilated COVID-19 patients were included in this retrospective study. The demographic and clinical data were compared between survivors and non-survivors, and Cox regression analysis was used to explore risk factors for 28-day mortality. The primary outcome was 28-day mortality after initiation of invasive ventilation. Secondary outcome was the time from admission to intubation. Results: Of 74 patients with COVID-19, the median age was 68.0 years, 53 (71.6%) were male, 47 (63.5%) had comorbidities with hypertension, and diabetes commonly presented. The most frequent symptoms were fever and dyspnea. The median time from hospital admission to intubation was similar in survivors and non-survivors (6.5 days vs. 5.0 days). The 28-day mortality was 81.1%. High Sequential Organ Failure Assessment (SOFA) score (hazard ratio [HR], 1.54; 95% confidence interval [CI], 1.23-1.92; p < 0.001) and longer time from hospital admission to intubation (HR, 2.41; 95% CI, 1.15-5.07; p = 0.020) were associated with 28-day mortality in invasively ventilated COVID-19 patients. Conclusions: The mortality of invasively ventilated COVID-19 patients was particularly striking. Patients with high SOFA score and receiving delayed invasive ventilation were at high risk of mortality.

Keywords: COVID-19; critically ill; invasive ventilation; mortality; risk factor.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curves. (A) The impact of age on mortality in critically ill patients with coronavirus disease 2019 (COVID-19). (B) The impact of high-sensitivity cardiac troponin I (hsTnI) level on mortality in critically ill patients with COVID-19. (C) The impact of time from hospital admission to invasive mechanical ventilation (IMV) on mortality in critically ill patients with COVID-19. Groups were compared by using log-rank test. All log-rank p value < 0.05. Numbers at risk are indicated.
See this image and copyright information in PMC

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