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Crit Care Explor . Inpatient Mortality According to Level of Respiratory Support Received for Severe Acute Respiratory Syndrome Coronavirus 2 (Coro

tetano

Editor, Senior Moderator
Crit Care Explor


. 2020 Sep 18;2(9):e0220.
doi: 10.1097/CCE.0000000000000220. eCollection 2020 Sep.
Inpatient Mortality According to Level of Respiratory Support Received for Severe Acute Respiratory Syndrome Coronavirus 2 (Coronavirus Disease 2019) Infection: A Prospective Multicenter Study


Alberto Palazzuoli[SUP] 1 [/SUP], Franco Ruberto[SUP] 2 [/SUP], Gaetano M De Ferrari[SUP] 3 [/SUP], Giovanni Forleo[SUP] 4 [/SUP], Gioel G Secco[SUP] 5 [/SUP], Gaetano M Ruocco[SUP] 6 [/SUP], Fabrizio D'Ascenzo[SUP] 3 [/SUP], Francesco Mojoli[SUP] 7 [/SUP], Silvia Monticone[SUP] 8 [/SUP], Anita Paggi[SUP] 9 [/SUP], Marco Vicenzi[SUP] 10 [/SUP], Silvia Corcione[SUP] 11 [/SUP], Anna G Palazzo[SUP] 11 [/SUP], Maurizio Landolina[SUP] 12 [/SUP], Erika Taravelli[SUP] 12 [/SUP], Guido Tavazzi[SUP] 7 [/SUP], Francesco Blasi[SUP] 13 [/SUP], Massimo Mancone[SUP] 14 [/SUP], Lucia I Birtolo[SUP] 14 [/SUP], Francesco Alessandri[SUP] 2 [/SUP], Fabio Infusino[SUP] 14 [/SUP], Francesco Pugliese[SUP] 2 [/SUP], Francesco Fedele[SUP] 14 [/SUP], Francesco Giuseppe De Rosa[SUP] 11 [/SUP], Michael Emmett[SUP] 15 [/SUP], Jeffrey M Schussler[SUP] 15 16 [/SUP], Peter A McCullough[SUP] 15 16 17 [/SUP], Kristen M Tecson[SUP] 17 [/SUP]



Affiliations

Abstract

Objectives: To describe patients according to the maximum degree of respiratory support received and report their inpatient mortality due to coronavirus disease 2019.
Design: Analysis of patients in the Coracle registry from February 22, 2020, to April 1, 2020.
Setting: Hospitals in the Piedmont, Lombardy, Tuscany, and Lazio regions of Italy.
Patients: Nine-hundred forty-eight patients hospitalized for coronavirus disease 2019.
Interventions: None.
Measurements and main results: Among 948 patients, 122 (12.87%) received invasive ventilation, 637 (67.19%) received supplemental oxygen only, and 189 (19.94%) received no respiratory support. The median (quartile 1-quartile 3) age was 65 years (54-76.59 yr), and there was evidence of differential respiratory treatment by decade of life (p = 0.0046); patients greater than 80 years old were generally not intubated. There were 606 men (63.9%) in this study, and they were more likely to receive respiratory support than women (p < 0.0001). The rate of in-hospital death for invasive ventilation recipients was 22.95%, 12.87% for supplemental oxygen recipients, and 7.41% for those who received neither (p = 0.0004). A sensitivity analysis of the 770 patients less than 80 years old revealed a lower, but similar mortality trend (18.02%, 8.10%, 5.23%; p = 0.0008) among the 14.42%, 65.71%, and 19.87% of patients treated with mechanical ventilation, supplemental oxygen only, or neither. Overall, invasive ventilation recipients who died were significantly older than those who survived (median age: 68.5 yr [60-81.36 yr] vs 62.5 yr [55.52-71 yr]; p = 0.0145).
Conclusions: Among patients hospitalized for coronavirus disease 2019, 13% received mechanical ventilation, which was associated with a mortality rate of 23%.

Keywords: coronavirus disease 2019; inpatient mortality; invasive ventilation; respiratory support; severe acute respiratory syndrome coronavirus 2; supplemental oxygen.
 
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