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Baseline characteristics and outcomes of patients with COVID-19 admitted to intensive care units in Vancouver, Canada: a case series.
CMAJ. 2020 06 29; 192(26):E694-E701.CMAJ

Abstract

BACKGROUND

Pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with high intensive care unit (ICU) mortality. We aimed to describe the clinical characteristics and outcomes of critically ill patients with coronavirus disease 2019 (COVID-19) in a Canadian setting.

METHODS

We conducted a retrospective case series of critically ill patients with laboratory-confirmed SARS-CoV-2 infection consecutively admitted to 1 of 6 ICUs in Metro Vancouver, British Columbia, Canada, between Feb. 21 and Apr. 14, 2020. Demographic, management and outcome data were collected by review of patient charts and electronic medical records.

RESULTS

Between Feb. 21 and Apr. 14, 2020, 117 patients were admitted to the ICU with a confirmed diagnosis of COVID-19. The median age was 69 (interquartile range [IQR] 60-75) years, and 38 (32.5%) were female. At least 1 comorbidity was present in 86 (73.5%) patients. Invasive mechanical ventilation was required in 74 (63.2%) patients. The duration of mechanical ventilation was 13.5 (IQR 8-22) days overall and 11 (IQR 6-16) days for patients successfully discharged from the ICU. Tocilizumab was administered to 4 patients and hydroxychloroquine to 1 patient. As of May 5, 2020, a total of 18 (15.4%) patients had died, 12 (10.3%) remained in the ICU, 16 (13.7%) were discharged from the ICU but remained in hospital, and 71 (60.7%) were discharged home.

INTERPRETATION

In our setting, mortality in critically ill patients with COVID-19 admitted to the ICU was lower than in previously published studies. These data suggest that the prognosis associated with critical illness due to COVID-19 may not be as poor as previously reported.

Authors+Show Affiliations

Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC.Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC.Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC.Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC.Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC.Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC.Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC.Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC.Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC.Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC.Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC.Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC donald.griesdale@ubc.ca.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32461326

Citation

Mitra, Anish R., et al. "Baseline Characteristics and Outcomes of Patients With COVID-19 Admitted to Intensive Care Units in Vancouver, Canada: a Case Series." CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, vol. 192, no. 26, 2020, pp. E694-E701.
Mitra AR, Fergusson NA, Lloyd-Smith E, et al. Baseline characteristics and outcomes of patients with COVID-19 admitted to intensive care units in Vancouver, Canada: a case series. CMAJ. 2020;192(26):E694-E701.
Mitra, A. R., Fergusson, N. A., Lloyd-Smith, E., Wormsbecker, A., Foster, D., Karpov, A., Crowe, S., Haljan, G., Chittock, D. R., Kanji, H. D., Sekhon, M. S., & Griesdale, D. E. G. (2020). Baseline characteristics and outcomes of patients with COVID-19 admitted to intensive care units in Vancouver, Canada: a case series. CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, 192(26), E694-E701. https://doi.org/10.1503/cmaj.200794
Mitra AR, et al. Baseline Characteristics and Outcomes of Patients With COVID-19 Admitted to Intensive Care Units in Vancouver, Canada: a Case Series. CMAJ. 2020 06 29;192(26):E694-E701. PubMed PMID: 32461326.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Baseline characteristics and outcomes of patients with COVID-19 admitted to intensive care units in Vancouver, Canada: a case series. AU - Mitra,Anish R, AU - Fergusson,Nicholas A, AU - Lloyd-Smith,Elisa, AU - Wormsbecker,Andrew, AU - Foster,Denise, AU - Karpov,Andrei, AU - Crowe,Sarah, AU - Haljan,Greg, AU - Chittock,Dean R, AU - Kanji,Hussein D, AU - Sekhon,Mypinder S, AU - Griesdale,Donald E G, Y1 - 2020/05/27/ PY - 2020/05/12/accepted PY - 2020/5/29/pubmed PY - 2020/7/14/medline PY - 2020/5/29/entrez SP - E694 EP - E701 JF - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne JO - CMAJ VL - 192 IS - 26 N2 - BACKGROUND: Pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with high intensive care unit (ICU) mortality. We aimed to describe the clinical characteristics and outcomes of critically ill patients with coronavirus disease 2019 (COVID-19) in a Canadian setting. METHODS: We conducted a retrospective case series of critically ill patients with laboratory-confirmed SARS-CoV-2 infection consecutively admitted to 1 of 6 ICUs in Metro Vancouver, British Columbia, Canada, between Feb. 21 and Apr. 14, 2020. Demographic, management and outcome data were collected by review of patient charts and electronic medical records. RESULTS: Between Feb. 21 and Apr. 14, 2020, 117 patients were admitted to the ICU with a confirmed diagnosis of COVID-19. The median age was 69 (interquartile range [IQR] 60-75) years, and 38 (32.5%) were female. At least 1 comorbidity was present in 86 (73.5%) patients. Invasive mechanical ventilation was required in 74 (63.2%) patients. The duration of mechanical ventilation was 13.5 (IQR 8-22) days overall and 11 (IQR 6-16) days for patients successfully discharged from the ICU. Tocilizumab was administered to 4 patients and hydroxychloroquine to 1 patient. As of May 5, 2020, a total of 18 (15.4%) patients had died, 12 (10.3%) remained in the ICU, 16 (13.7%) were discharged from the ICU but remained in hospital, and 71 (60.7%) were discharged home. INTERPRETATION: In our setting, mortality in critically ill patients with COVID-19 admitted to the ICU was lower than in previously published studies. These data suggest that the prognosis associated with critical illness due to COVID-19 may not be as poor as previously reported. SN - 1488-2329 UR - https://www.unboundmedicine.com/medline/citation/32461326/Baseline_characteristics_and_outcomes_of_patients_with_COVID_19_admitted_to_intensive_care_units_in_Vancouver_Canada:_a_case_series_ L2 - http://www.cmaj.ca/cgi/pmidlookup?view=long&pmid=32461326 DB - PRIME DP - Unbound Medicine ER -