scholarly journals Characteristics and Outcomes of Mechanically Ventilated COVID-19 Patients—An Observational Cohort Study

2020 ◽  
pp. 088506662095480
Author(s):  
Martin Krause ◽  
David J. Douin ◽  
Kevin K. Kim ◽  
Ana Fernandez-Bustamante ◽  
Karsten Bartels
Keyword(s):  
United States ◽  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Cohort Study ◽  
Intensive Care ◽  
The United States ◽  
Observational Cohort Study ◽  
Mechanically Ventilated ◽  
Independent Variables ◽  
Observational Cohort

Background: The United States currently has more confirmed cases of COVID-19 than any other country in the world. Given the variability in COVID-19 testing and prevention capability, identifying factors associated with mortality in patients requiring mechanical ventilation is critical. This study aimed to identify which demographics, comorbidities, markers of disease progression, and interventions are associated with 30-day mortality in COVID-19 patients requiring mechanical ventilation. Methods: Adult patients with a confirmed diagnosis of COVID-19 admitted to one of the health system’s intensive care units and requiring mechanical ventilation between March 9, 2020 and April 1, 2020, were included in this observational cohort study. We used Chi-Square and Mann-Whitney U tests to compare patient characteristics between deceased and living patients and multiple logistic regression to assess the association between independent variables and the likelihood of 30-day mortality. Results: We included 85 patients, of which 20 died (23.5%) within 30 days of the first hospital admission. In the univariate analysis, deceased patients were more likely ≥60 years of age (p < 0.001), non-Hispanic (p = 0.026), and diagnosed with a solid malignant tumor (p = 0.003). Insurance status also differed between survivors and non-survivors (p = 0.019). Age ≥60 and malignancy had a 9.5-fold (95% confidence interval 1.4-62.3, p = 0.020) and 5.8-fold higher odds ratio (95% confidence interval 1.2-28.4, p = 0.032) for 30-day mortality after adjusted analysis using multivariable logistic regression, while other independent variables were no longer significant. Conclusions: In our observational cohort study of 85 mechanically ventilated COVID-19 patients, age, and a diagnosis of a solid malignant tumor were associated with 30-day mortality. Our findings validate concerns for the survival of elderly and cancer patients in the face of the COVID-19 pandemic in the United States, where testing capabilities and preventative measures have been inconsistent. Preventative efforts geared to patients at risk for intensive care unit mortality from COVID-19 should be explored.

scholarly journals The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Antoni Torres ◽  
Anna Motos ◽  
Jordi Riera ◽  
Laia Fernández-Barat ◽  
Adrián Ceccato ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cohort Study ◽  
Prognostic Factor ◽  
Hospital Mortality ◽  
Clinical Data ◽  
Observational Cohort Study ◽  
Mechanically Ventilated ◽  
Icu Admission ◽  
Risk Of Death ◽  
Observational Cohort

Abstract Background Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0–171.2] to 180.0 [135.4–227.9] mmHg and the ventilatory ratio from 1.73 [1.33–2.25] to 1.96 [1.61–2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01–1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01–1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93–1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation.

Peripheral muscular ultrasound as outcome assessment tool in critically ill patients on mechanical ventilation: An observational cohort study

2021 ◽  
Author(s):  
Diogo Oliveira Toledo ◽  
Branca Jardini de Freitas ◽  
Rogério Dib ◽  
Flavia Julie do Amaral Pfeilsticker ◽  
Dyaiane Marques dos Santos ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cohort Study ◽  
Outcome Assessment ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Assessment Tool ◽  
Observational Cohort Study ◽  
Observational Cohort

Outcomes in patients requiring intensive care for CAR T-cell toxicity

2021 ◽  
pp. dtb-2021-000056
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
T Cell ◽  
Cell Therapy ◽  
Chimeric Antigen Receptor ◽  
Observational Cohort Study ◽  
Cell Toxicity ◽  
T Cell Therapy ◽  
Car T ◽  
Observational Cohort

AbstractOverview of: Azoulay É, Castro P, Maamar A, et al. Outcomes in patients treated with chimeric antigen receptor T-cell therapy who were admitted to intensive care (CARTTAS): an international, multicentre, observational cohort study. Lancet Haematol. 2021;8:e355–64.

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