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Clinical Characteristics and Outcomes of COVID-19 Patients Hospitalized in Intensive Care Unit
BACKGROUND: Meta-analysis and clinical studies suggest coronavirus disease-2019 (COVID-19) patients in ICU have a high mortality rate of 30–45%, which has evolved as a function of criteria of admission and the management modalities. MATERIALS AND METHODS: We conducted a retrospective evaluation for...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Jaypee Brothers Medical Publishers
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664017/ https://www.ncbi.nlm.nih.gov/pubmed/34963716 http://dx.doi.org/10.5005/jp-journals-10071-23945 |
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author | Pandit, Rahul A Gagana, BN Vaity, Charudatt Mulakavalupil, Bindu Choudhary, Jitendra S Jain, Vivek Chandan, Pramila M Joshi, Harsh |
author_facet | Pandit, Rahul A Gagana, BN Vaity, Charudatt Mulakavalupil, Bindu Choudhary, Jitendra S Jain, Vivek Chandan, Pramila M Joshi, Harsh |
author_sort | Pandit, Rahul A |
collection | PubMed |
description | BACKGROUND: Meta-analysis and clinical studies suggest coronavirus disease-2019 (COVID-19) patients in ICU have a high mortality rate of 30–45%, which has evolved as a function of criteria of admission and the management modalities. MATERIALS AND METHODS: We conducted a retrospective evaluation for characteristics and outcomes in critical care set up across six months. RESULTS: 514 patients (74.3% males and 25.6% females) were evaluated. 9.72% (n = 50) patients expired, 78% (n = 39) were males. Mean age (years) was 57 (±14, range 64, 95% CI 55–58). 65.7% (n = 338) were of age more than 50 years, of which 71.5% (n = 242) were males. Males at 20% higher risk for death than women. (RR = 1.2, 95% CI 0.66–2.31, p = 0.61 NS). There was 18% less risk of mortality in female vs male with comorbidities (RR 0.82, 95% CI 0.67–1.12, p = 0.32 NS). Risk for mortality in diabetics was significantly increased by 116% vs nondiabetics. (RR 2.16, p = 0.0055, 95% CI 1.28–3.67). Highly significant risk of mortality in age group >50 years (3.13 times higher) vs age ≤50 years. (RR 3.18, 95% CI 1.71–8.64, p = 0.0003). 50.2% had moderate ARDS at admission. High flow nasal cannula was used in 47.2%. There is 5.79 times more likelihood to be on the ventilator with moderate to severe ARDS vs mild ARDS (RR = 5.79, 95% CI 3.10–11.05, p <0.0001). Risk for death was six times higher for patients on ventilator vs not on ventilator (RR = 6.08, 95% CI 3.49–10.59, p <0.0001). The mean number of days on ventilator for patients who underwent tracheostomy (n = 49) was 14 days as compared to 6.6 days in patients who were extubated (n = 57) (p <0.0001). P/F ratio had negative correlation with number of days of hospitalisation (Pearson r -0.391, 95% CI -0.46– -0.31, p <0.0001). 67% less chances of mortality in patients on steroids (RR = 0.33, 95% CI 0.19–60, p = 0.0012). Mean duration of ICU stay (days) was 8 (± 5, range 29, 95% CI 7.5–8.4). CONCLUSIONS: We observed that a strict adherence to the basic principles of ARDS management resulted in a lower mortality in ICU setting. HOW TO CITE THIS ARTICLE: Pandit RA, Gagana BN, Vaity C, Mulakavalupil B, Choudhary JS, Jain V, et al. Clinical Characteristics and Outcomes of COVID-19 Patients Hospitalized in Intensive Care Unit. Indian J Crit Care Med 2021;25(9):992–1000. |
format | Online Article Text |
id | pubmed-8664017 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Jaypee Brothers Medical Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-86640172021-12-27 Clinical Characteristics and Outcomes of COVID-19 Patients Hospitalized in Intensive Care Unit Pandit, Rahul A Gagana, BN Vaity, Charudatt Mulakavalupil, Bindu Choudhary, Jitendra S Jain, Vivek Chandan, Pramila M Joshi, Harsh Indian J Crit Care Med Original Article BACKGROUND: Meta-analysis and clinical studies suggest coronavirus disease-2019 (COVID-19) patients in ICU have a high mortality rate of 30–45%, which has evolved as a function of criteria of admission and the management modalities. MATERIALS AND METHODS: We conducted a retrospective evaluation for characteristics and outcomes in critical care set up across six months. RESULTS: 514 patients (74.3% males and 25.6% females) were evaluated. 9.72% (n = 50) patients expired, 78% (n = 39) were males. Mean age (years) was 57 (±14, range 64, 95% CI 55–58). 65.7% (n = 338) were of age more than 50 years, of which 71.5% (n = 242) were males. Males at 20% higher risk for death than women. (RR = 1.2, 95% CI 0.66–2.31, p = 0.61 NS). There was 18% less risk of mortality in female vs male with comorbidities (RR 0.82, 95% CI 0.67–1.12, p = 0.32 NS). Risk for mortality in diabetics was significantly increased by 116% vs nondiabetics. (RR 2.16, p = 0.0055, 95% CI 1.28–3.67). Highly significant risk of mortality in age group >50 years (3.13 times higher) vs age ≤50 years. (RR 3.18, 95% CI 1.71–8.64, p = 0.0003). 50.2% had moderate ARDS at admission. High flow nasal cannula was used in 47.2%. There is 5.79 times more likelihood to be on the ventilator with moderate to severe ARDS vs mild ARDS (RR = 5.79, 95% CI 3.10–11.05, p <0.0001). Risk for death was six times higher for patients on ventilator vs not on ventilator (RR = 6.08, 95% CI 3.49–10.59, p <0.0001). The mean number of days on ventilator for patients who underwent tracheostomy (n = 49) was 14 days as compared to 6.6 days in patients who were extubated (n = 57) (p <0.0001). P/F ratio had negative correlation with number of days of hospitalisation (Pearson r -0.391, 95% CI -0.46– -0.31, p <0.0001). 67% less chances of mortality in patients on steroids (RR = 0.33, 95% CI 0.19–60, p = 0.0012). Mean duration of ICU stay (days) was 8 (± 5, range 29, 95% CI 7.5–8.4). CONCLUSIONS: We observed that a strict adherence to the basic principles of ARDS management resulted in a lower mortality in ICU setting. HOW TO CITE THIS ARTICLE: Pandit RA, Gagana BN, Vaity C, Mulakavalupil B, Choudhary JS, Jain V, et al. Clinical Characteristics and Outcomes of COVID-19 Patients Hospitalized in Intensive Care Unit. Indian J Crit Care Med 2021;25(9):992–1000. Jaypee Brothers Medical Publishers 2021-09 /pmc/articles/PMC8664017/ /pubmed/34963716 http://dx.doi.org/10.5005/jp-journals-10071-23945 Text en Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd. https://creativecommons.org/licenses/by-nc/4.0/© Jaypee Brothers Medical Publishers. 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Original Article Pandit, Rahul A Gagana, BN Vaity, Charudatt Mulakavalupil, Bindu Choudhary, Jitendra S Jain, Vivek Chandan, Pramila M Joshi, Harsh Clinical Characteristics and Outcomes of COVID-19 Patients Hospitalized in Intensive Care Unit |
title | Clinical Characteristics and Outcomes of COVID-19 Patients Hospitalized in Intensive Care Unit |
title_full | Clinical Characteristics and Outcomes of COVID-19 Patients Hospitalized in Intensive Care Unit |
title_fullStr | Clinical Characteristics and Outcomes of COVID-19 Patients Hospitalized in Intensive Care Unit |
title_full_unstemmed | Clinical Characteristics and Outcomes of COVID-19 Patients Hospitalized in Intensive Care Unit |
title_short | Clinical Characteristics and Outcomes of COVID-19 Patients Hospitalized in Intensive Care Unit |
title_sort | clinical characteristics and outcomes of covid-19 patients hospitalized in intensive care unit |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664017/ https://www.ncbi.nlm.nih.gov/pubmed/34963716 http://dx.doi.org/10.5005/jp-journals-10071-23945 |
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