• Stephen Su Yang, Jed Lipes, Sandra Dial, Blair Schwartz, Denny Laporta, Evan Wong, Craig Baldry, Paul Warshawsky, Patricia McMillan, David Hornstein, Michel de Marchie, and Dev Jayaraman.
• Departments of Anesthesia (Yang, Baldry, McMillan), Medicine (Lipes, Dial, Schwartz, Laporta, Warshawsky, Hornstein, de Marchie, Jayaraman) and Surgery (Wong), and Division of Critical Care (Yang, Lipes, Dial, Schwartz, Laporta, Wong, Baldry, Warshawsky, McMillan, Hornstein, de Marchie, Jayaraman), Jewish General Hospital, McGill University, Montréal, Que. Stephen.yang@mail.mcgill.ca.
• CMAJ Open. 2020 Oct 1; 8 (4): E788-E795.

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic is responsible for millions of infections worldwide, and a substantial number of these patients will be admitted to the intensive care unit (ICU). Our objective was to describe the characteristics, outcomes and management of critically ill patients with COVID-19 pneumonia at a single designated pandemic centre in Montréal, Canada.MethodsA descriptive analysis was performed on consecutive critically ill patients with COVID-19 pneumonia admitted to the ICU at the Jewish General Hospital, a designated pandemic centre in Montréal, between Mar. 5 and May 21, 2020. Complete follow-up data corresponding to death or discharge from hospital health records were included to Aug. 4, 2020. We summarized baseline characteristics, management and outcomes, including mortality.ResultsA total of 106 patients were included in this study. Twenty-one patients (19.8%) died during their hospital stay, and the ICU mortality was 17.0% (18/106); all patients were discharged home or died, except for 4 patients (2 awaiting a rehabilitation bed and 2 awaiting long-term care). Twelve of 65 patients (18.5%) requiring mechanical ventilation died. Prone positioning was used in 29 patients (27.4%), including in 10 patients who were spontaneously breathing; no patient was placed on extracorporeal membrane oxygenation. High-flow nasal cannula was used in 51 patients (48.1%). Acute kidney injury was the most common complication, seen in 20 patients (18.9%), and 12 patients (11.3%) required renal replacement therapy. A total of 53 patients (50.0%) received corticosteroids.InterpretationOur cohort of critically ill patients with COVID-19 had lower mortality than that previously described in other jurisdictions. These findings may help guide critical care decision-making in similar health care systems in further COVID-19 surges.Copyright 2020, Joule Inc. or its licensors.

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