Cent Eur J Public Health 2021, 29(1):3-8 | DOI: 10.21101/cejph.a6672
COVID-19 severe pneumonia: Prospective multicentre study on demands on intensive care capacities
- 1 Third Faculty of Medicine, Charles University, and Department of Infectious Diseases, Hospital Na Bulovce, Prague, Czech Republic
- 2 First Faculty of Medicine, Charles University, and Department of Anaesthesiology and Critical Care, Thomayer Hospital, Prague, Czech Republic
- 3 Third Faculty of Medicine, Charles University, and Department of Infectious Diseases, Masaryk Hospital, Ústí nad Labem, Czech Republic
- 4 First Faculty of Medicine, Charles University, and Department of Anaesthesiology, Resuscitation and Intensive Medicine, General University Hospital, Prague, Czech Republic
- 5 Third Faculty of Medicine, Charles University, and Department of Anaesthesiology, Resuscitation and Intensive Medicine, University Hospital Královské Vinohrady, Prague, Czech Republic
- 6 Department of Anaesthesiology and Reanimation, Hospital Na Homolce, Prague, Czech Republic
- 7 Second Faculty of Medicine, Charles University, and Department of Anaesthesiology, Resuscitation and Intensive Medicine, Motol University Hospital, Prague, Czech Republic
- 8 Department of Anaesthesiology and Resuscitation, Hospital Na Bulovce, Prague, Czech Republic
- 9 Second Faculty of Medicine, Charles University, and Department of Cardiology, Motol University Hospital, Prague, Czech Republic
Objectives: The aim of the study was to obtain data on demands on the intensive care capacities to treat COVID-19 patients, and to identify predictors for in-hospital mortality.
Methods: The prospective observational multicentre study carried out from 1 March till 30 June 2020 included adult patients with confirmed SARS-CoV-2 infection with respiratory failure requiring ventilatory support or high-flow nasal oxygen therapy (HFNO).
Results: Seventy-four patients, 46 males and 28 females, median age 67.5 (Q1-Q3: 56-75) years, were included. Sixty-four patients (86.5%) had comorbidity. Sixty-six patients (89.2%) were mechanically ventilated, four of them received extracorporeal membrane oxygenation therapy. Eight patients (10.8%) were treated with non-invasive ventilation and HFNO only. The median of intensive care unit (ICU) stay was 22.5 days. Eighteen patients (24.3%) needed continuous renal replacement therapy. Thirty patients (40.5%) died. Age and acute kidney injury were identified as independent predictors of in-hospital death, and chronic kidney disease showed trend towards statistical significance for poor outcome.
Conclusions: Sufficient number of intensive care beds, organ support equipment and well-trained staff is a decisive factor in managing the COVID-19 epidemic. The study focused on the needs of intensive care in the COVID-19 patients. Advanced age and acute kidney injury were identified as independent predictors for in-hospital mortality. When compared to clinical course and ICU management of patients with severe community-acquired pneumonia caused by other pathogens, we observed prolonged need for ventilatory support, high rate of progression to acute respiratory distress syndrome and significant mortality in studied population.
Keywords: COVID-19, respiratory failure, kidney disease, intensive care, mortality
Received: December 14, 2020; Revised: March 5, 2021; Accepted: March 5, 2021; Published: March 31, 2021 Show citation
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