Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State - JAM
Letter, description of clinical presentation, characteristics and outcomes of CIVID-19.
- Poor short-term outcomes among patients requiring mechanical ventilation.
- 21 cases included, mean age 70, 52% male, 86% comorbidities (most common: chronic kidney disease (47.6%) and congestive heart failure (42.9%)).
- Main initial symptoms: shortness of breath (76%), fever (52%), and cough (48%).
- Mean onset of symptoms prior to hospital presentation: 3.5 days.
- 17/21 (81%) admitted to the ICU <24 hours after hospital admission.
- Abnormal chest X-ray in 20 patients (95%) at admission. Most common findings: bilateral reticular nodular opacities (11 [52%]) and ground-glass opacities (10 [48%]).
- By 72h hours, 86% had bilateral reticular nodular opacities and 67% had evidence of ground-glass opacities.
- The mean white blood cell count was 9365 μL at admission, 14/21 (67%) had a normal white blood cell count. 14/21 (67%) had an absolute lymphocyte count of <1000 cells/μL. Liver function tests were abnormal in 8/21 (38%) at admission.
- Mechanical ventilation was initiated in 15/21 (71%), ARDS observed in 15/15 and 8 of 15 (53%) developed severe ARDS by <72 hours.
- Cardiomyopathy developed in 7 patients (33%).
- Mortality was 67% and 24% of patients have remained critically ill and 9.5% have been discharged from the ICU.