Tags

Type your tag names separated by a space and hit enter

Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China.
Crit Care. 2020 07 06; 24(1):394.CC

Abstract

BACKGROUND

The global numbers of confirmed cases and deceased critically ill patients with COVID-19 are increasing. However, the clinical course, and the 60-day mortality and its predictors in critically ill patients have not been fully elucidated. The aim of this study is to identify the clinical course, and 60-day mortality and its predictors in critically ill patients with COVID-19.

METHODS

Critically ill adult patients admitted to intensive care units (ICUs) from 3 hospitals in Wuhan, China, were included. Data on demographic information, preexisting comorbidities, laboratory findings at ICU admission, treatments, clinical outcomes, and results of SARS-CoV-2 RNA tests and of serum SARS-CoV-2 IgM were collected including the duration between symptom onset and negative conversion of SARS-CoV-2 RNA.

RESULTS

Of 1748 patients with COVID-19, 239 (13.7%) critically ill patients were included. Complications included acute respiratory distress syndrome (ARDS) in 164 (68.6%) patients, coagulopathy in 150 (62.7%) patients, acute cardiac injury in 103 (43.1%) patients, and acute kidney injury (AKI) in 119 (49.8%) patients, which occurred 15.5 days, 17 days, 18.5 days, and 19 days after the symptom onset, respectively. The median duration of the negative conversion of SARS-CoV-2 RNA was 30 (range 6-81) days in 49 critically ill survivors that were identified. A total of 147 (61.5%) patients deceased by 60 days after ICU admission. The median duration between ICU admission and decease was 12 (range 3-36). Cox proportional-hazards regression analysis revealed that age older than 65 years, thrombocytopenia at ICU admission, ARDS, and AKI independently predicted the 60-day mortality.

CONCLUSIONS

Severe complications are common and the 60-day mortality of critically ill patients with COVID-19 is considerably high. The duration of the negative conversion of SARS-CoV-2 RNA and its association with the severity of critically ill patients with COVID-19 should be seriously considered and further studied.

Authors+Show Affiliations

Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Research Center for Translational Medicine, Jinyintan Hospital, Wuhan, China.Department of ICU/Emergency Wuhan Third Hospital, Wuhan University, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Research Center for Translational Medicine, Jinyintan Hospital, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of ICU/Emergency Wuhan Third Hospital, Wuhan University, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Research Center for Translational Medicine, Jinyintan Hospital, Wuhan, China.Research Center for Translational Medicine, Jinyintan Hospital, Wuhan, China.Department of Critical Care Medicine, Xiangyang No.1 Hospital, Affiliated Hospital of Hubei University of Medicine, Xiangyang, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. shiying_yuan@163.com.Research Center for Translational Medicine, Jinyintan Hospital, Wuhan, China. 1813886398@qq.com.Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. you_shanghust@163.com. Research Center for Translational Medicine, Jinyintan Hospital, Wuhan, China. you_shanghust@163.com.

Pub Type(s)

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

Language

eng

PubMed ID

32631393

Citation

Xu, Jiqian, et al. "Clinical Course and Predictors of 60-day Mortality in 239 Critically Ill Patients With COVID-19: a Multicenter Retrospective Study From Wuhan, China." Critical Care (London, England), vol. 24, no. 1, 2020, p. 394.
Xu J, Yang X, Yang L, et al. Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China. Crit Care. 2020;24(1):394.
Xu, J., Yang, X., Yang, L., Zou, X., Wang, Y., Wu, Y., Zhou, T., Yuan, Y., Qi, H., Fu, S., Liu, H., Xia, J., Xu, Z., Yu, Y., Li, R., Ouyang, Y., Wang, R., Ren, L., Hu, Y., ... Shang, Y. (2020). Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China. Critical Care (London, England), 24(1), 394. https://doi.org/10.1186/s13054-020-03098-9
Xu J, et al. Clinical Course and Predictors of 60-day Mortality in 239 Critically Ill Patients With COVID-19: a Multicenter Retrospective Study From Wuhan, China. Crit Care. 2020 07 6;24(1):394. PubMed PMID: 32631393.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China. AU - Xu,Jiqian, AU - Yang,Xiaobo, AU - Yang,Luyu, AU - Zou,Xiaojing, AU - Wang,Yaxin, AU - Wu,Yongran, AU - Zhou,Ting, AU - Yuan,Yin, AU - Qi,Hong, AU - Fu,Shouzhi, AU - Liu,Hong, AU - Xia,Jia'an, AU - Xu,Zhengqin, AU - Yu,Yuan, AU - Li,Ruiting, AU - Ouyang,Yaqi, AU - Wang,Rui, AU - Ren,Lehao, AU - Hu,Yingying, AU - Xu,Dan, AU - Zhao,Xin, AU - Yuan,Shiying, AU - Zhang,Dingyu, AU - Shang,You, Y1 - 2020/07/06/ PY - 2020/04/25/received PY - 2020/06/17/accepted PY - 2020/7/8/entrez PY - 2020/7/8/pubmed PY - 2020/7/10/medline KW - Acute kidney injury KW - Acute respiratory syndrome KW - COVID-19 KW - Mortality KW - Thrombocytopenia SP - 394 EP - 394 JF - Critical care (London, England) JO - Crit Care VL - 24 IS - 1 N2 - BACKGROUND: The global numbers of confirmed cases and deceased critically ill patients with COVID-19 are increasing. However, the clinical course, and the 60-day mortality and its predictors in critically ill patients have not been fully elucidated. The aim of this study is to identify the clinical course, and 60-day mortality and its predictors in critically ill patients with COVID-19. METHODS: Critically ill adult patients admitted to intensive care units (ICUs) from 3 hospitals in Wuhan, China, were included. Data on demographic information, preexisting comorbidities, laboratory findings at ICU admission, treatments, clinical outcomes, and results of SARS-CoV-2 RNA tests and of serum SARS-CoV-2 IgM were collected including the duration between symptom onset and negative conversion of SARS-CoV-2 RNA. RESULTS: Of 1748 patients with COVID-19, 239 (13.7%) critically ill patients were included. Complications included acute respiratory distress syndrome (ARDS) in 164 (68.6%) patients, coagulopathy in 150 (62.7%) patients, acute cardiac injury in 103 (43.1%) patients, and acute kidney injury (AKI) in 119 (49.8%) patients, which occurred 15.5 days, 17 days, 18.5 days, and 19 days after the symptom onset, respectively. The median duration of the negative conversion of SARS-CoV-2 RNA was 30 (range 6-81) days in 49 critically ill survivors that were identified. A total of 147 (61.5%) patients deceased by 60 days after ICU admission. The median duration between ICU admission and decease was 12 (range 3-36). Cox proportional-hazards regression analysis revealed that age older than 65 years, thrombocytopenia at ICU admission, ARDS, and AKI independently predicted the 60-day mortality. CONCLUSIONS: Severe complications are common and the 60-day mortality of critically ill patients with COVID-19 is considerably high. The duration of the negative conversion of SARS-CoV-2 RNA and its association with the severity of critically ill patients with COVID-19 should be seriously considered and further studied. SN - 1466-609X UR - https://www.unboundmedicine.com/medline/citation/32631393/Clinical_course_and_predictors_of_60_day_mortality_in_239_critically_ill_patients_with_COVID_19:_a_multicenter_retrospective_study_from_Wuhan_China_ L2 - https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-03098-9 DB - PRIME DP - Unbound Medicine ER -