Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 25;16(3):e0249038.
doi: 10.1371/journal.pone.0249038. eCollection 2021.

ICU outcomes and survival in patients with severe COVID-19 in the largest health care system in central Florida

Eduardo Oliveira  1 , Amay Parikh  1 , Arnaldo Lopez-Ruiz  1 , Maria Carrilo  1 , Joshua Goldberg  1 , Martin Cearras  1 , Khaled Fernainy  1 , Sonja Andersen  1 , Luis Mercado  2 , Jian Guan  2 , Hammad Zafar  2 , Patricia Louzon  3 , Amy Carr  3 , Natasha Baloch  1 , Richard Pratley  4 , Scott Silverstry  5 , Vincent Hsu  6 , Jason Sniffen  6 , Victor Herrera  6 , Neil Finkler  7
Affiliations

ICU outcomes and survival in patients with severe COVID-19 in the largest health care system in central Florida

Eduardo Oliveira et al. PLoS One. .

Abstract

Background: Observational studies have consistently described poor clinical outcomes and increased ICU mortality in patients with severe coronavirus disease 2019 (COVID-19) who require mechanical ventilation (MV). Our study describes the clinical characteristics and outcomes of patients with severe COVID-19 admitted to ICU in the largest health care system in the state of Florida, United States.

Methods: Retrospective cohort study of patients admitted to ICU due to severe COVID-19 in AdventHealth health system in Orlando, Florida from March 11th until May 18th, 2020. Patients were characterized based on demographics, baseline comorbidities, severity of illness, medical management including experimental therapies, laboratory markers and ventilator parameters. Major clinical outcomes analyzed at the end of the study period were: hospital and ICU length of stay, MV-related mortality and overall hospital mortality of ICU patients.

Results: Out of total of 1283 patients with COVID-19, 131 (10.2%) met criteria for ICU admission (median age: 61 years [interquartile range (IQR), 49.5-71.5]; 35.1% female). Common comorbidities were hypertension (84; 64.1%), and diabetes (54; 41.2%). Of the 131 ICU patients, 109 (83.2%) required MV and 9 (6.9%) received ECMO. Lower positive end expiratory pressure (PEEP) were observed in survivors [9.2 (7.7-10.4)] vs non-survivors [10 (9.1-12.9] p = 0.004]. Compared to non-survivors, survivors had a longer MV length of stay (LOS) [14 (IQR 8-22) vs 8.5 (IQR 5-10.8) p< 0.001], Hospital LOS [21 (IQR 13-31) vs 10 (7-1) p< 0.001] and ICU LOS [14 (IQR 7-24) vs 9.5 (IQR 6-11), p < 0.001]. The overall hospital mortality and MV-related mortality were 19.8% and 23.8% respectively. After exclusion of hospitalized patients, the hospital and MV-related mortality rates were 21.6% and 26.5% respectively.

Conclusions: Our study demonstrates an important improvement in mortality of patients with severe COVID-19 who required ICU admission and MV in comparison to previous observational reports and emphasizes the importance of standard of care measures in the management of COVID-19.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study flow diagram of patients with COVID-19 admitted to Intensive Care Unit (ICU).
See this image and copyright information in PMC

References

    1. Team CC-R. Geographic Differences in COVID-19 Cases, Deaths, and Incidence—United States, February 12-April 7, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):465–71. Epub 2020/04/17. 10.15585/mmwr.mm6915e4 . - DOI - PMC - PubMed
    1. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239–42. Epub 2020/02/25. 10.1001/jama.2020.2648 . - DOI - PubMed
    1. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al.. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020. Epub 2020/04/23. 10.1001/jama.2020.6775 . - DOI - PMC - PubMed
    1. Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al.. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323(16):1574–81. Epub 2020/04/07. 10.1001/jama.2020.5394 . - DOI - PMC - PubMed
    1. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al.. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054–62. Epub 2020/03/15. 10.1016/S0140-6736(20)30566-3 . - DOI - PMC - PubMed

MeSH terms