COVID-19 research briefs: case series of critically ill patients in the intensive care unit

Daily POEMs

Published: 2020-04-19 © 2020 John Wiley & Sons, Inc.

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Clinical question
What is the prognosis for critically ill patients infected with COVID-19?

Bottom line
Very preliminary evidence demonstrates poor short-term outcomes for people with COVID-19 who require mechanical ventilation. (LOE = 4)

Arentz M, Yim E, Klaff L, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington state. JAMA 2020 Mar 19. doi: 10.1001/jama.2020.4326. [Epub ahead of print]

Study design: Case series

Funding source: Unknown/not stated

Setting: Inpatient (any location)

Research Brief #5 (Arentz, 2020) A report published on March 19, 2020, reports on a case series of 21 critically ill COVID-19 patients at a single intensive care unit (ICU) in Washington state. Patients were admitted between February 20 and March 5, 2020. The mean age of patients was 70 years (range = 42 to 90 years) and 11 of 21 were men. Patients had symptoms an average of 3.5 days prior to hospital admission. Lymphopenia was seen in 67% of patients. Comorbidities were common, including chronic kidney disease (48%), heart failure (43%), diabetes (33%), chronic obstructive pulmonary disease (33%), and obstructive sleep apnea (29%), with 86% of patients having at least one comorbidity. These results are similar to those from a published series in China. Fifteen patients required mechanical ventilation due to acute respiratory distress syndrome, with one-third developing cardiomyopathy. As of March 17, 14 patients had died, 5 remained in the ICU, and 2 had been discharged.

Mark H. Ebell, MD, MS
University of Georgia
Athens, GA

Copyright © 2020 John Wiley & Sons, Inc.