ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019.

• Type of Material: Article
• Authors: Sara Auld, Emory University; Mark Caridi-Scheible, Emory University; James Blum, Emory University; Chad Robichaux, Emory University; Colleen Kraft, Emory University; Jesse Jacob, Emory University; Craig Jabaley, Emory University; David Carpenter, Emory University; Roberta Kaplow, Emory University; Alfonso C. Hernandez-Romieu, Emory University; Max W. Adelman, Emory University; Gregory Martin, Emory University; Craig M. Coopersmith, Emory University; David Murphy, Emory University
• Language: English
• Date: 2020-05-26
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Final Published Version
• Copyright Statement: © 2020 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
• License: Creative Commons Universal : Public Domain Dedication
• Final Published Version (URL): http://dx.doi.org/10.1097/CCM.0000000000004457
• Title of Journal or Parent Work: Critical Care Medicine
• ISSN: 0090-3493
• Grant/Funding Information: This work was supported by the following grants: National Institutes of Health (NIH)/National Institute of Allergy and Infectious Diseases K23 AI134182 (to Dr. Auld), NIH/Clinical and Translational Science Awards UL1TR002378.
• Keywords: ICU; ventilator; critically ill; COVID-19; mortality
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Pathology

Abstract

OBJECTIVES: To determine mortality rates among adults with critical illness from coronavirus disease 2019. DESIGN: Observational cohort study of patients admitted from March 6, 2020, to April 17, 2020. SETTING: Six coronavirus disease 2019 designated ICUs at three hospitals within an academic health center network in Atlanta, Georgia, United States. PATIENTS: Adults greater than or equal to 18 years old with confirmed severe acute respiratory syndrome-CoV-2 disease who were admitted to an ICU during the study period. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among 217 critically ill patients, mortality for those who required mechanical ventilation was 35.7% (59/165), with 4.8% of patients (8/165) still on the ventilator at the time of this report. Overall mortality to date in this critically ill cohort is 30.9% (67/217) and 60.4% (131/217) patients have survived to hospital discharge. Mortality was significantly associated with older age, lower body mass index, chronic renal disease, higher Sequential Organ Failure Assessment score, lower PaO2/FIO2 ratio, higher D-dimer, higher C-reactive protein, and receipt of mechanical ventilation, vasopressors, renal replacement therapy, or vasodilator therapy. CONCLUSIONS: Despite multiple reports of mortality rates exceeding 50% among critically ill adults with coronavirus disease 2019, particularly among those requiring mechanical ventilation, our early experience indicates that many patients survive their critical illness.