Baseline Characteristics and Outcomes of 21 Critically Ill Patients with COVID – 19 in Washington State

Posted by

Salient Points

This study of 21 critically ill patients with COVID-19 in Washington State, USA found:

  • Mostly older patients ( mean age 70 y, range 43-92), 52 % male
  • , lab findings and Xray findings were similar to others studies
  • Most (86%) had co-morbidities
  • ARDS observed in 100% cases – all required mechanical ventilation.
  • 53% of which developed Severe ARDS by 72 hours.
  • Cardiomyopathy developed in 33 %
  • High mortality of 67%.

Detailed Summary

  • Mean Age of COVID-19 patient – 70 y/o
  • Range of patients admitted – 43 – 92 y/o
  • 52% of Patients being Male.
  • No of Patients reported to have Comorbidities – 18 (86%)
  • Most Common Comorbidities
    1. CKD – 47.6 %
    2. Congestive Heart Failure – CHF – 42.9 %
    3. COPD – 33.3%
    4. Diabetes – 33.3%
    5. OSAS – 28.6%
    6. Immunosuppression – 14.3 %
    7. End Stage Renal Disease – 9.5%
    8. H/O Solid Organ Transplant – 9.5%
    9. Asthma – 9.1 %
    10. Rheumatologic Disease – 4.8%
    11. Cirrhosis – 4.8%
  • Initial Symptoms
  1. Shortness of Breath – 76%
  2. Fever – 52%
  3. Cough – 48%
  4. Range of Temperature – 35.3 – 39.2 – Mean – 37.6 (Degrees C)

The mean onset of symptoms prior to admission to the hospital was 3.5 days and 17 patients (81%) were admitted to the ICU less than 24 hours after admission.

Chest Radiograph Findings on Admission

  • B/L Reticular Nodular Opacities – 52.4%
  • GGO/GGA – Ground Glass Opacities – 47.6%
  • Pleural Effusion – 28.6%
  • Peribronchial thickening – 23.8%
  • Focal Consolidation – 19.0%
  • Pulmonary Edema – 9.5%
  • Venous Congestion – 4.8%
  • Atelectasis – 4.8%
  • Clear – 4.8%

Chest Radiograph Finding after 72 hours

  • Patients with B/L reticular nodular opacities – 86%
  • Evidence of GGO – 67%

Blood Reports at Admission

  • Mean WBC – 9,365 μL
  • Normal WBC Count observed in 14 patients (67%)
  • Absolute Lymphocyte Count < 1000 cells/μL observed in 14 patients (67%)
  • Liver function tests were abnormal in 8 patients (38%) at admission

Pulmonary Findings

  • ARDS observed in 100% cases – all required mechanical ventilation.
  • 53% of which developed Severe ARDS by 72 hours.

Cardiovascular Findings

  • Cardiomyopathy developed in 33% of patients.

Conclusions

  • As of 17th March 2020, the Mortality was calculated to be 67%.
  • 24% of patients remained critically ill.
  • 5% of patients were discharged from the ICU.

Reference Link : https://jamanetwork.com/journals/jama/fullarticle/2763485

Leave a Reply

Your email address will not be published. Required fields are marked *