• Medicina intensiva · Jan 2021

    Observational Study

    Acute respiratory distress syndrome due to COVID-19. Clinical and prognostic features from a medical Critical Care Unit in Valencia, Spain.

    • P Ramírez, M Gordón, M Martín-Cerezuela, E Villarreal, E Sancho, M Padrós, J Frasquet, G Leyva, I Molina, M Barrios, S Gimeno, and Á Castellanos.
    • Critical care department, Hospital Universitario y Politécnico la Fe, Valencia, Spain.
    • Med Intensiva. 2021 Jan 1; 45 (1): 273427-34.

    ObjectiveInformation from critically ill coronavirus disease 2019 (COVID-19) patients is limited and in many cases coming from health systems approaches different from the national public systems existing in most countries in Europe. Besides, patient follow-up remains incomplete in many publications. Our aim is to characterize acute respiratory distress syndrome (ARDS) patients admitted to a medical critical care unit (MCCU) in a referral hospital in Spain.DesignRetrospective case series of consecutive ARDS COVID-19 patients admitted and treated in our MCCU.Setting36-bed MCCU in referral tertiary hospital.Patients And ParticipantsSARS-CoV-2 infection confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay of nasal/pharyngeal swabs.InterventionsNone.Main Variables Of InterestDemographic and clinical data were collected, including data on clinical management, respiratory failure, and patient mortality.ResultsForty-four ARDS COVID-19 patients were included in the study. Median age was 61.50 (53.25 - 67) years and most of the patients were male (72.7%). Hypertension and dyslipidemia were the most frequent co-morbidities (52.3 and 36.4% respectively). Steroids (1mg/Kg/day) and tocilizumab were administered in almost all patients (95.5%). 77.3% of the patients needed invasive mechanical ventilation for a median of 16 days [11-28]. Prone position ventilation was performed in 33 patients (97%) for a median of 3 sessions [2-5] per patient. Nosocomial infection was diagnosed in 13 patients (29.5%). Tracheostomy was performed in ten patients (29.4%). At study closing all patients had been discharged from the CCU and only two (4.5%) remained in hospital ward. MCCU length of stay was 18 days [10-27]. Mortality at study closing was 20.5% (n 9); 26.5% among ventilated patients.ConclusionsThe seven-week period in which our MCCU was exclusively dedicated to COVID-19 patients has been challenging. Despite the severity of the patients and the high need for invasive mechanical ventilation, mortality was 20.5%.© 2020 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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