• A Rodríguez, G Moreno, J Gómez, R Carbonell, E Picó-Plana, C Benavent Bofill, R Sánchez Parrilla, S Trefler, E Esteve Pitarch, L Canadell, X Teixido, L Claverias, M Bodí, por el HJ23-COVID-19 working group, Listado de Investigadores del HJ23-COVID-19 Working Group. Laboratorio clínico, Epidemiología y prevención de la infección nosocomial, Departamento de enfermería UCI, Farmacia clínica, Médicos UCI, and UCI Data-Analitics.
• Servicio de Medicina Intensiva, Hospital Universitari de Tarragona Joan XXIII, Tarragona, España; URV/IIPSV/CIBERES, España. Electronic address: ahr1161@yahoo.es.
• Med Intensiva. 2020 Dec 1; 44 (9): 525-533.

ObjectiveTo describe the clinical and respiratory characteristics of a cohort of 43 patients with COVID-19 after an evolutive period of 28 days.DesignA prospective, single-center observational study was carried out.SettingIntensive care.PatientsPatients admitted due to COVID-19 and respiratory failure.InterventionsNone.VariablesAutomatic recording was made of demographic variables, severity parameters, laboratory data, assisted ventilation (HFO: high-flow oxygen therapy and IMV: invasive mechanical ventilation), oxygenation (PaO2, PaO2/FiO2) and complications. The patients were divided into three groups: survivors (G1), deceased (G2) and patients remaining under admission (G3). The chi-squared test or Fisher exact test (categorical variables) was used, along with the Mann-Whitney U-test or Wilcoxon test for analyzing the differences between medians. Statistical significance was considered for p<0.05.ResultsA total of 43 patients were included (G1=28 [65.1%]; G2=10 [23.3%] and G3=5 [11.6%]), with a mean age of 65 years (range: 52-72), 62% males, APACHE II 18 (15-24), SOFA 6 (4-7). Arterial hypertension (30.2%) and obesity (25.6%) were the most frequent comorbidities. High-flow oxygen therapy was used in 62.7% of the patients, with failure in 85%. In turn, 95% of the patients required IMV and 85% received ventilation in prone decubitus. In the general population, initial PaO2/FiO2 improved after 7 days (165 [125-210] vs.194 [153-285]; p=0.02), in the same way as in G1 (164 [125-197] vs. 207 [160-294]; p=0.07), but not in G2 (163 [95-197] vs. 135 [85-177]). No bacterial coinfection was observed. The incidence of IMV-associated pneumonia was high (13 episodes/1000 days of IMV).ConclusionsPatients with COVID-19 require early IMV, a high frequency of ventilation in prone decubitus, and have a high incidence of failed HFO. The lack of improvement of PaO2/FiO2 at 7 days could be a prognostic marker. .Copyright © 2020 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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