Short-Term Outcomes of Patients With COVID-19 Undergoing Invasive Mechanical Ventilation: A Retrospective Observational Study From Wuhan, China

Frontiers in Medicine

article

Shuai Zhao¹  Yun Lin¹  Cheng Zhou²  Li Wang¹  Xueyin Chen¹  Sean P. Clifford³  Ozan Akca³  Jiapeng Huang³  Xiangdong Chen¹ 

[1] Department of Anesthesiology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology;Laboratory of Anesthesia and Critical Care Medicine, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital of Sichuan University;Department of Anesthesiology and Perioperative Medicine, University of Louisville, United States

关键词: COVID-19;    SARS-CoV-2;    invasive mechanical ventilation;    critically ill patients;    outcomes;   

DOI  :  10.3389/fmed.2020.571542

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: COVID-19 has spread rapidly worldwide. Many patients require mechanical ventilation. The goal of this study was to investigate the clinical course and outcomes of patients with COVID-19 undergoing mechanical ventilation and identify factors associated with death. Methods: Eighty-three consecutive critically ill patients with confirmed COVID-19 undergoing invasive mechanical ventilation were included in this retrospective, single-center, observational study from January 31 to March 15, 2020. Demographic, clinical, laboratory, radiological, and mechanical ventilation data were collected and analyzed. The primary outcome was 28-day mortality after endotracheal intubation. The secondary outcomes included the incidences of SARS-CoV-2-related cardiac, liver, and kidney injury. Results: Seventy-four out of 83 (89.2%) patients achieved oxygen saturation above 93% after intubation. Forty-nine out of 83 (59%) patients died and 34 (41%) patients survived after 28 days of observation. Multivariable regression showed increasing odds of death associated with cardiac injury (odds ratio 15.60, 95% CI 4.20–74.43), liver injury (5.40, 1.46–23.56), and kidney injury (8.39, 1.63–61.41), and decreasing odds of death associated with the higher PaO 2 /FiO 2 ratio before intubation (0.97, 0.95–0.99). PaO 2 /FiO 2 ratio before intubation demonstrated a positive linear correlation with platelet count ( r = 0.424, P = 0.001), and negative linear correlation with troponin I ( r = −0.395, P = 0.008). Conclusions: Cardiac, liver, and kidney injury may be associated with death for critically ill patients with COVID-19 undergoing invasive mechanical ventilation. The severity of pre-intubation hypoxia may be associated with a poorer outcome of patients with COVID-19 undergoing invasive mechanical ventilation. Larger, multi-institutional, prospective studies should be conducted to confirm these preliminary results.

【 授权许可】

CC BY