• Lowell Ling, Christina So, Hoi Ping Shum, ChanPaul K SPKSDepartment of Microbiology, The Chinese University of Hong Kong, Hong Kong, China., Christopher K C Lai, Darshana H Kandamby, Eunise Ho, Dominic So, Wing Wa Yan, Grace Lui, Wai Shing Leung, Man Chun Chan, and Charles D Gomersall.
• Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, China. lowell.ling@cuhk.edu.hk
• Crit Care Resusc. 2020 Apr 6; 22 (2): 119125119-125.

ObjectiveTo report the first eight cases of critically ill patients with coronavirus disease 2019 (COVID-19) in Hong Kong, describing the treatments and supportive care they received and their 28-day outcomes.DesignMulticentre retrospective observational cohort study.SettingThree multidisciplinary intensive care units (ICUs) in Hong Kong.ParticipantsAll adult critically ill patients with confirmed COVID-19 admitted to ICUs in Hong Kong between 22 January and 11 February 2020.Main Outcome Measure28-day mortality.ResultsEight out of 49 patients with COVID-19 (16%) were admitted to Hong Kong ICUs during the study period. The median age was 64.5 years (range, 42–70) with a median admission Sequential Organ Failure Assessment (SOFA) score of 6 (IQR, 4–7). Six patients (75%) required mechanical ventilation, six patients (75%) required vasopressors and two (25%) required renal replacement therapy. None of the patients required prone ventilation, nitric oxide or extracorporeal membrane oxygenation. The median times to shock reversal and extubation were 9 and 11 days respectively. At 28 days, one patient (12%) had died and the remaining seven (88%) all survived to ICU discharge. Only one of the survivors (14%) still required oxygen at 28 days.ConclusionCritically ill patients with COVID-19 often require a moderate duration of mechanical ventilation and vasopressor support. Most of these patients recover and survive to ICU discharge with supportive care using lung protective ventilation strategies, avoiding excess fluids, screening and treating bacterial co-infection, and timely intubation. Lower rather than upper respiratory tract viral burden correlates with clinical severity of illness.

23 keywords...

hide…