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Clinical Course and Outcomes of Severe Covid-19: A National Scale Study

Knowledge of the outcomes of critically ill patients is crucial for health and government officials who are planning how to address local outbreaks. The factors associated with outcomes of critically ill patients with coronavirus disease 2019 (Covid-19) who required treatment in an intensive care un...

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Autores principales: Amit, Moran, Sorkin, Alex, Chen, Jacob, Cohen, Barak, Karol, Dana, Tsur, Avishai M, Lev, Shaul, Rozenblat, Tal, Dvir, Ayana, Landau, Geva, Fridrich, Lidar, Glassberg, Elon, Kesari, Shani, Sviri, Sigal, Gelman, Ram, Miller, Asaf, Epstein, Danny, Ben-Avi, Ronny, Matan, Moshe, Jakobson, Daniel J., Bader, Tarif, Dahan, David, King, Daniel A., Ben-Ari, Anat, Soroksky, Arie, Bar, Alon, Fink, Noam, Singer, Pierre, Benov, Avi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408944/
https://www.ncbi.nlm.nih.gov/pubmed/32708357
http://dx.doi.org/10.3390/jcm9072282
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author Amit, Moran
Sorkin, Alex
Chen, Jacob
Cohen, Barak
Karol, Dana
Tsur, Avishai M
Lev, Shaul
Rozenblat, Tal
Dvir, Ayana
Landau, Geva
Fridrich, Lidar
Glassberg, Elon
Kesari, Shani
Sviri, Sigal
Gelman, Ram
Miller, Asaf
Epstein, Danny
Ben-Avi, Ronny
Matan, Moshe
Jakobson, Daniel J.
Bader, Tarif
Dahan, David
King, Daniel A.
Ben-Ari, Anat
Soroksky, Arie
Bar, Alon
Fink, Noam
Singer, Pierre
Benov, Avi
author_facet Amit, Moran
Sorkin, Alex
Chen, Jacob
Cohen, Barak
Karol, Dana
Tsur, Avishai M
Lev, Shaul
Rozenblat, Tal
Dvir, Ayana
Landau, Geva
Fridrich, Lidar
Glassberg, Elon
Kesari, Shani
Sviri, Sigal
Gelman, Ram
Miller, Asaf
Epstein, Danny
Ben-Avi, Ronny
Matan, Moshe
Jakobson, Daniel J.
Bader, Tarif
Dahan, David
King, Daniel A.
Ben-Ari, Anat
Soroksky, Arie
Bar, Alon
Fink, Noam
Singer, Pierre
Benov, Avi
author_sort Amit, Moran
collection PubMed
description Knowledge of the outcomes of critically ill patients is crucial for health and government officials who are planning how to address local outbreaks. The factors associated with outcomes of critically ill patients with coronavirus disease 2019 (Covid-19) who required treatment in an intensive care unit (ICU) are yet to be determined. Methods: This was a retrospective registry-based case series of patients with laboratory-confirmed SARS-CoV-2 who were referred for ICU admission and treated in the ICUs of the 13 participating centers in Israel between 5 March and 27 April 2020. Demographic and clinical data including clinical management were collected and subjected to a multivariable analysis; primary outcome was mortality. Results: This study included 156 patients (median age = 72 years (range = 22–97 years)); 69% (108 of 156) were male. Eighty-nine percent (139 of 156) of patients had at least one comorbidity. One hundred three patients (66%) required invasive mechanical ventilation. As of 8 May 2020, the median length of stay in the ICU was 10 days (range = 0–37 days). The overall mortality rate was 56%; a multivariable regression model revealed that increasing age (OR = 1.08 for each year of age, 95%CI = 1.03–1.13), the presence of sepsis (OR = 1.08 for each year of age, 95%CI = 1.03–1.13), and a shorter ICU stay(OR = 0.90 for each day, 95% CI = 0.84–0.96) were independent prognostic factors. Conclusions: In our case series, we found lower mortality rates than those in exhausted health systems. The results of our multivariable model suggest that further evaluation is needed of antiviral and antibacterial agents in the treatment of sepsis and secondary infection.
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spelling pubmed-74089442020-08-13 Clinical Course and Outcomes of Severe Covid-19: A National Scale Study Amit, Moran Sorkin, Alex Chen, Jacob Cohen, Barak Karol, Dana Tsur, Avishai M Lev, Shaul Rozenblat, Tal Dvir, Ayana Landau, Geva Fridrich, Lidar Glassberg, Elon Kesari, Shani Sviri, Sigal Gelman, Ram Miller, Asaf Epstein, Danny Ben-Avi, Ronny Matan, Moshe Jakobson, Daniel J. Bader, Tarif Dahan, David King, Daniel A. Ben-Ari, Anat Soroksky, Arie Bar, Alon Fink, Noam Singer, Pierre Benov, Avi J Clin Med Article Knowledge of the outcomes of critically ill patients is crucial for health and government officials who are planning how to address local outbreaks. The factors associated with outcomes of critically ill patients with coronavirus disease 2019 (Covid-19) who required treatment in an intensive care unit (ICU) are yet to be determined. Methods: This was a retrospective registry-based case series of patients with laboratory-confirmed SARS-CoV-2 who were referred for ICU admission and treated in the ICUs of the 13 participating centers in Israel between 5 March and 27 April 2020. Demographic and clinical data including clinical management were collected and subjected to a multivariable analysis; primary outcome was mortality. Results: This study included 156 patients (median age = 72 years (range = 22–97 years)); 69% (108 of 156) were male. Eighty-nine percent (139 of 156) of patients had at least one comorbidity. One hundred three patients (66%) required invasive mechanical ventilation. As of 8 May 2020, the median length of stay in the ICU was 10 days (range = 0–37 days). The overall mortality rate was 56%; a multivariable regression model revealed that increasing age (OR = 1.08 for each year of age, 95%CI = 1.03–1.13), the presence of sepsis (OR = 1.08 for each year of age, 95%CI = 1.03–1.13), and a shorter ICU stay(OR = 0.90 for each day, 95% CI = 0.84–0.96) were independent prognostic factors. Conclusions: In our case series, we found lower mortality rates than those in exhausted health systems. The results of our multivariable model suggest that further evaluation is needed of antiviral and antibacterial agents in the treatment of sepsis and secondary infection. MDPI 2020-07-18 /pmc/articles/PMC7408944/ /pubmed/32708357 http://dx.doi.org/10.3390/jcm9072282 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Amit, Moran
Sorkin, Alex
Chen, Jacob
Cohen, Barak
Karol, Dana
Tsur, Avishai M
Lev, Shaul
Rozenblat, Tal
Dvir, Ayana
Landau, Geva
Fridrich, Lidar
Glassberg, Elon
Kesari, Shani
Sviri, Sigal
Gelman, Ram
Miller, Asaf
Epstein, Danny
Ben-Avi, Ronny
Matan, Moshe
Jakobson, Daniel J.
Bader, Tarif
Dahan, David
King, Daniel A.
Ben-Ari, Anat
Soroksky, Arie
Bar, Alon
Fink, Noam
Singer, Pierre
Benov, Avi
Clinical Course and Outcomes of Severe Covid-19: A National Scale Study
title Clinical Course and Outcomes of Severe Covid-19: A National Scale Study
title_full Clinical Course and Outcomes of Severe Covid-19: A National Scale Study
title_fullStr Clinical Course and Outcomes of Severe Covid-19: A National Scale Study
title_full_unstemmed Clinical Course and Outcomes of Severe Covid-19: A National Scale Study
title_short Clinical Course and Outcomes of Severe Covid-19: A National Scale Study
title_sort clinical course and outcomes of severe covid-19: a national scale study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408944/
https://www.ncbi.nlm.nih.gov/pubmed/32708357
http://dx.doi.org/10.3390/jcm9072282
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