Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy - JAMA
By: G. Grasselli, et al.
Describe clinical characteristics of COVID-19 patients admitted to the ICUs of Lombardy.
- Clinical characteristics of 1591 ICU-patients in Lombardy are described
- 99% required respiratory support, 88% intubation and mechanical ventilation and 11% non-invasive ventilation.
- ICU mortality was 26% while 58% of patients was still admitted to the ICU at study closure.
- All COVID-19 patients (= positive RT-PCR of nasal and pharyngeal swabs) admitted to the ICU’s of 72 Lombardy between 20-2 and 18-3 were included.
- 1591 inclusions, 82% male, median age 63, 23% was 71 years or older, 13% was younger than 50.
- Hypertension most common comorbidity (49%). Cardiovascular disease and hypercholesterolemia were second and third most common.
- 99% of ICU admitted patients required (non)-invasive respiratory support, 88% were intubated and mechanically ventilated. Median PEEP was 14 cm H20. 89% required FiO2 of at least 50%. 12% required 100%. 27% required prone ventilation en 1% ECMO at admission
- Hypertensive patients had higher ventilation requirements
- 58% of patients were still at ICU when the study closed, 16% were discharged from ICU and 26% had died (underestimation since 58% of patients was still on ICU at study closure). Mortality rates were higher among elderly and hypertensive patients.
- Median ICU length of stay was 8 days for discharged patients. And 10 days for patients still admitted (underestimation).
- Mechanical ventilation rates in this study is much higher compared to other literature which is probably due to non-invasively ventilated patients being treated on wards in Italy and therefore not requiring ICU admittance (and exclusion of the current study).
- 63 is also the median age of all infected Italian patients indicating older age is not a risk factor for ICU admittance.