Clinical Features and Prognosis of Invasive Ventilation in Hospitalized Patients with COVID-19: A Retrospective Study

Poupak Rahimzadeh; Hamid Reza Faiz; Reza Farahmandrad; Babak Hassanlouei; Azadeh Habibi; Setareh Hedayati Emami; Saied Amniati

doi:10.5812/aapm.108773

Clinical Features and Prognosis of Invasive Ventilation in Hospitalized Patients with COVID-19: A Retrospective Study

Anesth Pain Med. 2020 Dec 19;10(6):e108773. doi: 10.5812/aapm.108773. eCollection 2020 Dec.

Authors

Poupak Rahimzadeh¹, Hamid Reza Faiz², Reza Farahmandrad², Babak Hassanlouei³, Azadeh Habibi², Setareh Hedayati Emami², Saied Amniati²

Affiliations

¹ Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.
² Rasoul Akram Hospital Clinical Research Development Center ( RCRDC), Tehran, Iran.
³ Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Background: World Health Organization (WHO) declared that the outbreak of COVID-19 constituted a public health emergency of global concern.

Objectives: Owing to limited data on critically ill patients admitted to ICU, we aimed to describe the clinical characteristics and prognosis of these patients based on ventilatory variables and clinical features.

Methods: In this retrospective study, 45 critically ill patients with laboratory-confirmed COVID-19 who were admitted to Intensive Care Unit (ICU) wards of the hospital from April 8 to May 9, 2020, were enrolled. Medical files of the patients were reviewed, and demographic and clinical characteristics, laboratory data, lung CT scan findings, causes of intubation, and outcomes of the patients were all collected.

Results: The median age of the patients was 67 years (range 22 to 91), 64% were men, and hypertension was the most common comorbidity. History of close contact with previously confirmed patients was positive in 62.2% of the patients. The mean time from symptom onset to hospital admission was 5.98 ± 2.93 days. The most common symptoms at the onset of illness were dyspnea (95.6%), and gastrointestinal symptoms (22.2%) were rare. The average length of the intubation was 4.84 ± 3.28 days. The distribution of intubation causes in the deceased patients was significantly more than the recovered patients (P = 0.031). The mean score of lung CT involvement in deaths (370.26 ± 207.50) was significantly higher than the recovered patients (235.71 ± 81.21) (P = 0.042). Length of the intubation had a statistically direct correlation with respiratory rate (P = 0.03).

Conclusions: Most of the critically ill patients admitted to ICU were older men and had poor outcomes with a high mortality rate. Furthermore, the score of chest CT involvement and respiratory rate are important prognostic factors in determining the severity of the illness, requiring ventilatory support, and outcome.

Keywords: COVID-19; Critically Ill Patients; Mortality; SARS-Cov-2; Ventilation.