Timing and causes of death in severe COVID-19 patients

Critical Care

Benjamin Glenn Chousterman¹  Charles de Roquetaillade¹  Albin Gouhier²  Maxime Leclerc³  Jean-François Llitjos⁴  Annabelle Stoclin⁴  Swann Bredin⁵  Frédéric Pène⁵  Jean-Baptiste Lascarrou⁶  Thibaud Soumagne⁷  Gaël Piton⁷  Mariana Cojocaru⁸ 

[1] Department of Anesthesiology and Critical Care, Hôpital Lariboisière, FHU PROMICE, DMU Parabol, APHP. Nord, Paris, France;Inserm U942 MASCOT, Paris, France;Intensive Care Unit, Centre Hospitalier Intercommunal Alençon Mamers, Alençon, France;Intensive Care Unit, Centre Hospitalier Mémorial France Etats-Unis, Saint-Lô, France;Intensive Care Unit, Gustave Roussy, Université Paris-Saclay, Villejuif, France;Intensive Care Unit, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris Centre, Paris, France;Intensive Care Unit, Hôpital Hôtel-Dieu, Nantes, France;Intensive Care Unit, Hôpital Jean Minjoz Hospital, Besançon, France;Surgical Intensive Care Unit, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris Centre, Paris, France;

关键词: COVID-19;    SARS-CoV-2;    Intensive care unit;    Mortality;    Causes of death;   

DOI  :  10.1186/s13054-021-03639-w

来源: Springer

【 摘 要 】

BackgroundPrevious studies reporting the causes of death in patients with severe COVID-19 have provided conflicting results. The objective of this study was to describe the causes and timing of death in patients with severe COVID-19 admitted to the intensive care unit (ICU).MethodsWe performed a retrospective study in eight ICUs across seven French hospitals. All consecutive adult patients (aged ≥ 18 years) admitted to the ICU with PCR-confirmed SARS-CoV-2 infection and acute respiratory failure were included in the analysis. The causes and timing of ICU deaths were reported based on medical records.ResultsFrom March 1, 2020, to April 28, 287 patients were admitted to the ICU for SARS-CoV-2 related acute respiratory failure. Among them, 93 patients died in the ICU (32%). COVID-19-related multiple organ dysfunction syndrome (MODS) was the leading cause of death (37%). Secondary infection-related MODS accounted for 26% of ICU deaths, with a majority of ventilator-associated pneumonia. Refractory hypoxemia/pulmonary fibrosis was responsible for death in 19% of the cases. Fatal ischemic events (venous or arterial) occurred in 13% of the cases. The median time from ICU admission to death was 15 days (25th–75th IQR, 7–27 days). COVID-19-related MODS had a median time from ICU admission to death of 14 days (25th–75th IQR: 7–19 days), while only one death had occurred during the first 3 days since ICU admission.ConclusionsIn our multicenter observational study, COVID-19-related MODS and secondary infections were the two leading causes of death, among severe COVID-19 patients admitted to the ICU.

【 授权许可】

CC BY