Clinical Characteristics and Outcomes in Patients Admitted in ICU with Severe COVID-19 in a Tertiary Care Hospital in North India: A Retrospective Observational Study
Journal of Cellular & Molecular Anesthesia,
Vol. 6 No. 4 (2021),
21 January 2022
,
Page 315-322
https://doi.org/10.22037/jcma.v7i1.36533
Abstract
Background: Many studies have reported poor clinical outcomes regarding the ICU course of patients with severe COVID 19. Our study aimed at prospectively observing the predominant clinical pattern and outcomes in patients with severe COVID 19 admitted in the ICU.
Materials and Methods: This study was a retrospective, observational study of 100 patients admitted to the ICU with confirmed COVID 19. Data from all patients with confirmed COVID 19 admitted in ICU between 15 March 2021 to 25 April 2021 was included for this study. Patients were studied for their demographics, baseline comorbidities, laboratory investigations, and details of treatment. Major outcomes analyzed were clinical presentation, mechanical ventilation (MV) related mortality, and overall mortality of ICU patients. Student's independent t-test for comparing continuous variables and Chi-square test for categorical variables.
Results: Out of 220 patients with COVID-19, 100 were admitted to the ICU. The most common comorbidities were hypertension (38) and diabetes (25). Twenty-eight patients required mechanical ventilation (MV), out of which only 16 survived. MV LOS was longer for survivors than non-survivors. The overall mortality rate in ICU patients was 25%, and MV-related mortality was 42.85%.
Conclusion: The severity of presenting symptoms and presentation time play a major role in the outcome. Our study reports higher mortality in patients who required mechanical ventilation. This could be because of the increased severity of disease in these patients.
- COVID 19
- ICU outcomes
- North India
- Retrospective
How to Cite
References
Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020;323(20):2052-9.
Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323(16):1574-81.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62.
Myers LC, Parodi SM, Escobar GJ, Liu VX. Characteristics of Hospitalized Adults With COVID-19 in an Integrated Health Care System in California. JAMA. 2020;323(21):2195-8.
Bhatraju PK, Ghassemieh BJ, Nichols M, Kim R, Jerome KR, Nalla AK, et al. Covid-19 in Critically Ill Patients in the Seattle Region - Case Series. N Engl J Med. 2020;382(21):2012-22.
Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo FX, Chong M, et al. Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State. JAMA. 2020;323(16):1612-4.
Wang Y, Lu X, Li Y, Chen H, Chen T, Su N, et al. Clinical Course and Outcomes of 344 Intensive Care Patients with COVID-19. Am J Respir Crit Care Med. 2020;201(11):1430-4.
Kayina CA, Haritha D, Soni L, Behera S, Nair PR, Gouri M, et al. Epidemiological & clinical characteristics & early outcome of COVID-19 patients in a tertiary care teaching hospital in India: A preliminary analysis. Indian J Med Res. 2020;152(1 & 2):100-4.
Shukla U, Chavali S, Mukta P, Mapari A, Vyas A. Initial Experience of Critically Ill Patients with COVID-19 in Western India: A Case Series. Indian J Crit Care Med. 2020;24(7):509-13.
Rajalu BM, Jacob J, Harihara SN, Kandasamy A, Ramalingaiah AH, Gopalakrishna KN, et al. Adopted COVID Care Centre Model with Mental Health Promotion at a Non-COVID Hospital: NIMHANS Experience. Indian J Psychol Med. 2020;42(6):584-5.
Varghese GM, John R, Manesh A, Karthik R, Abraham OC. Clinical management of COVID-19. Indian J Med Res. 2020;151(5):401-10.
Cavalcanti AB, Suzumura É A, Laranjeira LN, Paisani DM, Damiani LP, Guimarães HP, et al. Effect of Lung Recruitment and Titrated Positive End-Expiratory Pressure (PEEP) vs Low PEEP on Mortality in Patients With Acute Respiratory Distress Syndrome: A Randomized Clinical Trial. JAMA. 2017;318(14):1335-45.
Mohan A, Tiwari P, Bhatnagar S, Patel A, Maurya A, Dar L, et al. Clinico-demographic profile & hospital outcomes of COVID-19 patients admitted at a tertiary care centre in north India. Indian J Med Res. 2020;152(1 & 2):61-9.
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.
Vaporidi K, Akoumianaki E, Telias I, Goligher EC, Brochard L, Georgopoulos D. Respiratory Drive in Critically Ill Patients. Pathophysiology and Clinical Implications. Am J Respir Crit Care Med. 2020;201(1):20-32.
Manning HL, Schwartzstein RM. Pathophysiology of dyspnea. N Engl J Med. 1995;333(23):1547-53.
Oldani S, Ravaglia C, Bensai S, Bertolovic L, Ghirotti C, Puglisi S, et al. Pathophysiology of light phenotype SARS-CoV-2 interstitial pneumonia: from histopathological features to clinical presentations. Pulmonology. 2021.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95(7):834-47.
Oliveira E, Parikh A, Lopez-Ruiz A, Carrilo M, Goldberg J, Cearras M, et al. ICU outcomes and survival in patients with severe COVID-19 in the largest health care system in central Florida. PLoS One. 2021;16(3):e0249038.
Gattinoni L, Chiumello D, Rossi S. COVID-19 pneumonia: ARDS or not? Crit Care. 2020;24(1):154.
Grasselli G, Tonetti T, Protti A, Langer T, Girardis M, Bellani G, et al. Pathophysiology of COVID-19-associated acute respiratory distress syndrome: a multicentre prospective observational study. Lancet Respir Med. 2020;8(12):1201-8.
- Abstract Viewed: 149 times
- PDF Downloaded: 129 times