Critical Care and Shock

Clinical characteristics and outcomes of critically ill COVID-19 patients admitted to an Infectious Diseases Intensive Care Unit in Portugal

Abstract

Objective: We aimed to describe the characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) admitted to an intensive care unit (ICU) in Portugal.

Design: This is an observational retrospective study. Demographic and clinical data were collected. Respiratory failure treated with invasive mechanical ventilation (IMV) and death during ICU stay were the main outcomes evaluated.

Setting: This study was conducted in the Infectious Diseases ICU of Centro Hospitalar e Universitário de São João, in Porto, Portugal, between March 11 and August 17, 2020.

Patients and participants: All consecutive patients with confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, admitted to the ICU during the study period were enrolled, and 62 patients were included.

Measurements and results: The median age was 71 years (IQR, 54-78) and 39 (62.9%) were male. Thirty-four (54.8%) patients received IMV in contrast to 28 (45.2%) who were not intubated and the median lowest PaO2/FiO2 was 86 (IQR, 70-113) in IMV and 150 (94-257) in non-IMV patients. Several patients with severe hypoxemic COVID-19 were treated without IMV, especially with high flow nasal cannula (HFNC). Overall mortality was 21.8% and older age, male sex, active cancer, lower lymphocyte count, higher aspartate aminotransferase (AST) level, and higher creatinine level at admission, hematologic dysfunction, and renal dysfunction during ICU stay were all associated with fatal outcome. Mortality was lower than observed in other series of critically ill patients, although comparisons are limited by different ICU admission criteria, management practices, and duration of follow-up.

Conclusions: This study provides data regarding the characteristics and outcomes of COVID-19 critically ill patients that can be used to optimize ICU preparedness in the future.