tetano
Editor, Senior Moderator
J Clin Med
. 2020 Jul 18;9(7):E2282.
doi: 10.3390/jcm9072282.
Clinical Course and Outcomes of Severe Covid-19: A National Scale Study
Moran Amit[SUP] 1 [/SUP], Alex Sorkin[SUP] 2 3 [/SUP], Jacob Chen[SUP] 2 4 [/SUP], Barak Cohen[SUP] 5 6 [/SUP], Dana Karol[SUP] 5 [/SUP], Avishai M Tsur[SUP] 2 7 8 [/SUP], Shaul Lev[SUP] 8 9 [/SUP], Tal Rozenblat[SUP] 8 10 [/SUP], Ayana Dvir[SUP] 11 [/SUP], Geva Landau[SUP] 2 3 [/SUP], Lidar Fridrich[SUP] 12 [/SUP], Elon Glassberg[SUP] 2 13 14 [/SUP], Shani Kesari[SUP] 2 15 [/SUP], Sigal Sviri[SUP] 16 [/SUP], Ram Gelman[SUP] 2 17 [/SUP], Asaf Miller[SUP] 18 [/SUP], Danny Epstein[SUP] 2 19 [/SUP], Ronny Ben-Avi[SUP] 20 21 [/SUP], Moshe Matan[SUP] 14 21 [/SUP], Daniel J Jakobson[SUP] 22 23 [/SUP], Tarif Bader[SUP] 2 24 [/SUP], David Dahan[SUP] 25 [/SUP], Daniel A King[SUP] 25 26 [/SUP], Anat Ben-Ari[SUP] 27 [/SUP], Arie Soroksky[SUP] 8 28 [/SUP], Alon Bar[SUP] 29 30 [/SUP], Noam Fink[SUP] 2 24 [/SUP], Pierre Singer[SUP] 8 31 [/SUP], Avi Benov[SUP] 2 14 [/SUP]
Affiliations
Abstract
Knowledge of the outcomes of critically ill patients is crucial for health and government officials who are planning how to address local outbreaks. The factors associated with outcomes of critically ill patients with coronavirus disease 2019 (Covid-19) who required treatment in an intensive care unit (ICU) are yet to be determined.
Methods: This was a retrospective registry-based case series of patients with laboratory-confirmed SARS-CoV-2 who were referred for ICU admission and treated in the ICUs of the 13 participating centers in Israel between 5 March and 27 April 2020. Demographic and clinical data including clinical management were collected and subjected to a multivariable analysis; primary outcome was mortality.
Results: This study included 156 patients (median age = 72 years (range = 22-97 years)); 69% (108 of 156) were male. Eighty-nine percent (139 of 156) of patients had at least one comorbidity. One hundred three patients (66%) required invasive mechanical ventilation. As of 8 May 2020, the median length of stay in the ICU was 10 days (range = 0-37 days). The overall mortality rate was 56%; a multivariable regression model revealed that increasing age (OR = 1.08 for each year of age, 95%CI = 1.03-1.13), the presence of sepsis (OR = 1.08 for each year of age, 95%CI = 1.03-1.13), and a shorter ICU stay(OR = 0.90 for each day, 95% CI = 0.84-0.96) were independent prognostic factors.
Conclusions: In our case series, we found lower mortality rates than those in exhausted health systems. The results of our multivariable model suggest that further evaluation is needed of antiviral and antibacterial agents in the treatment of sepsis and secondary infection.
Keywords: ARDS; ICU; comorbidities; covid-19; mortality; prognosis.
. 2020 Jul 18;9(7):E2282.
doi: 10.3390/jcm9072282.
Clinical Course and Outcomes of Severe Covid-19: A National Scale Study
Moran Amit[SUP] 1 [/SUP], Alex Sorkin[SUP] 2 3 [/SUP], Jacob Chen[SUP] 2 4 [/SUP], Barak Cohen[SUP] 5 6 [/SUP], Dana Karol[SUP] 5 [/SUP], Avishai M Tsur[SUP] 2 7 8 [/SUP], Shaul Lev[SUP] 8 9 [/SUP], Tal Rozenblat[SUP] 8 10 [/SUP], Ayana Dvir[SUP] 11 [/SUP], Geva Landau[SUP] 2 3 [/SUP], Lidar Fridrich[SUP] 12 [/SUP], Elon Glassberg[SUP] 2 13 14 [/SUP], Shani Kesari[SUP] 2 15 [/SUP], Sigal Sviri[SUP] 16 [/SUP], Ram Gelman[SUP] 2 17 [/SUP], Asaf Miller[SUP] 18 [/SUP], Danny Epstein[SUP] 2 19 [/SUP], Ronny Ben-Avi[SUP] 20 21 [/SUP], Moshe Matan[SUP] 14 21 [/SUP], Daniel J Jakobson[SUP] 22 23 [/SUP], Tarif Bader[SUP] 2 24 [/SUP], David Dahan[SUP] 25 [/SUP], Daniel A King[SUP] 25 26 [/SUP], Anat Ben-Ari[SUP] 27 [/SUP], Arie Soroksky[SUP] 8 28 [/SUP], Alon Bar[SUP] 29 30 [/SUP], Noam Fink[SUP] 2 24 [/SUP], Pierre Singer[SUP] 8 31 [/SUP], Avi Benov[SUP] 2 14 [/SUP]
Affiliations
- PMID: 32708357
- DOI: 10.3390/jcm9072282
Abstract
Knowledge of the outcomes of critically ill patients is crucial for health and government officials who are planning how to address local outbreaks. The factors associated with outcomes of critically ill patients with coronavirus disease 2019 (Covid-19) who required treatment in an intensive care unit (ICU) are yet to be determined.
Methods: This was a retrospective registry-based case series of patients with laboratory-confirmed SARS-CoV-2 who were referred for ICU admission and treated in the ICUs of the 13 participating centers in Israel between 5 March and 27 April 2020. Demographic and clinical data including clinical management were collected and subjected to a multivariable analysis; primary outcome was mortality.
Results: This study included 156 patients (median age = 72 years (range = 22-97 years)); 69% (108 of 156) were male. Eighty-nine percent (139 of 156) of patients had at least one comorbidity. One hundred three patients (66%) required invasive mechanical ventilation. As of 8 May 2020, the median length of stay in the ICU was 10 days (range = 0-37 days). The overall mortality rate was 56%; a multivariable regression model revealed that increasing age (OR = 1.08 for each year of age, 95%CI = 1.03-1.13), the presence of sepsis (OR = 1.08 for each year of age, 95%CI = 1.03-1.13), and a shorter ICU stay(OR = 0.90 for each day, 95% CI = 0.84-0.96) were independent prognostic factors.
Conclusions: In our case series, we found lower mortality rates than those in exhausted health systems. The results of our multivariable model suggest that further evaluation is needed of antiviral and antibacterial agents in the treatment of sepsis and secondary infection.
Keywords: ARDS; ICU; comorbidities; covid-19; mortality; prognosis.