Early experience with critically ill patients with COVID-19 in Montreal
Purpose Montreal has been the epicentre of the coronavirus disease (COVID-19) pandemic in Canada. Given the regional disparities in incidence and mortality in the general population, we aimed to describe local characteristics, treatments, and outcomes of critically ill COVID-19 patients in Montreal. Methods A single-centre retrospective cohort of consecutive adult patients admitted to the intensive care unit (ICU) of Hôpital du Sacré-Coeur de Montréal with confirmed COVID-19 were included. Results Between 20 March and 13 May 2020, 75 patients were admitted, with a median [interquartile range (IQR)] age of 62 [53–72] yr and high rates of obesity (47%), hypertension (67%), and diabetes (37%). Healthcare-related infections were responsible for 35% of cases. The median [IQR] day 1 sequential organ failure assessment score was 6 [3–7]. Invasive mechanical ventilation (IMV) was used in 57% of patients for a median [IQR] of 11 [5–22] days. Patients receiving IMV were characterized by a moderately decreased median [IQR] partial pressure of oxygen:fraction of inspired oxygen (day 1 $ PaO_{2} $:$ F_{i} %$ O_{2} $ = 177 [138–276]; day 10 = 173 [147–227]) and compliance (day 1 = 48 [38–58] mL/$ cmH_{2} $O; day 10 = 34 [28–42] mL/$ cmH_{2} $O) and very elevated estimated dead space fraction (day 1 = 0.60 [0.53–0.67]; day 10 = 0.72 [0.69–0.79]). Overall hospital mortality was 25%, and 21% in the IMV patients. Mortality was 82% in patients ≥ 80 yr old. Conclusions Characteristics and outcomes of critically ill patients with COVID-19 in Montreal were similar to those reported in the existing literature. We found an increased physiologic dead space, supporting the hypothesis that pulmonary vascular injury may be central to COVID-19-induced lung damage..
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:68 |
|---|---|
| Enthalten in: |
Canadian journal of anesthesia - 68(2020), 2 vom: 15. Sept., Seite 204-213 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Cavayas, Yiorgos Alexandros [VerfasserIn] |
|---|
| Links: |
Volltext [lizenzpflichtig] |
|---|
| Themen: |
Acute respiratory distress syndrome |
|---|
| Anmerkungen: |
© Canadian Anesthesiologists' Society 2020. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
|---|
| doi: |
10.1007/s12630-020-01816-z |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
SPR042856736 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | SPR042856736 | ||
| 003 | DE-627 | ||
| 005 | 20240104064700.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 210126s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s12630-020-01816-z |2 doi | |
| 035 | |a (DE-627)SPR042856736 | ||
| 035 | |a (SPR)s12630-020-01816-z-e | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Cavayas, Yiorgos Alexandros |e verfasserin |0 (orcid)0000-0001-7664-2104 |4 aut | |
| 245 | 1 | 0 | |a Early experience with critically ill patients with COVID-19 in Montreal |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a © Canadian Anesthesiologists' Society 2020. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. | ||
| 520 | |a Purpose Montreal has been the epicentre of the coronavirus disease (COVID-19) pandemic in Canada. Given the regional disparities in incidence and mortality in the general population, we aimed to describe local characteristics, treatments, and outcomes of critically ill COVID-19 patients in Montreal. Methods A single-centre retrospective cohort of consecutive adult patients admitted to the intensive care unit (ICU) of Hôpital du Sacré-Coeur de Montréal with confirmed COVID-19 were included. Results Between 20 March and 13 May 2020, 75 patients were admitted, with a median [interquartile range (IQR)] age of 62 [53–72] yr and high rates of obesity (47%), hypertension (67%), and diabetes (37%). Healthcare-related infections were responsible for 35% of cases. The median [IQR] day 1 sequential organ failure assessment score was 6 [3–7]. Invasive mechanical ventilation (IMV) was used in 57% of patients for a median [IQR] of 11 [5–22] days. Patients receiving IMV were characterized by a moderately decreased median [IQR] partial pressure of oxygen:fraction of inspired oxygen (day 1 $ PaO_{2} $:$ F_{i} %$ O_{2} $ = 177 [138–276]; day 10 = 173 [147–227]) and compliance (day 1 = 48 [38–58] mL/$ cmH_{2} $O; day 10 = 34 [28–42] mL/$ cmH_{2} $O) and very elevated estimated dead space fraction (day 1 = 0.60 [0.53–0.67]; day 10 = 0.72 [0.69–0.79]). Overall hospital mortality was 25%, and 21% in the IMV patients. Mortality was 82% in patients ≥ 80 yr old. Conclusions Characteristics and outcomes of critically ill patients with COVID-19 in Montreal were similar to those reported in the existing literature. We found an increased physiologic dead space, supporting the hypothesis that pulmonary vascular injury may be central to COVID-19-induced lung damage. | ||
| 650 | 4 | |a COVID-19 |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a intensive care |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a mechanical ventilation |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a acute respiratory distress syndrome |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Noël, Alexandre |4 aut | |
| 700 | 1 | |a Brunette, Veronique |4 aut | |
| 700 | 1 | |a Williamson, David |4 aut | |
| 700 | 1 | |a Frenette, Anne Julie |4 aut | |
| 700 | 1 | |a Arsenault, Christine |4 aut | |
| 700 | 1 | |a Bellemare, Patrick |4 aut | |
| 700 | 1 | |a Lagrenade-Verdant, Colin |4 aut | |
| 700 | 1 | |a LeGuillan, Soazig |4 aut | |
| 700 | 1 | |a Levesque, Emilie |4 aut | |
| 700 | 1 | |a Lamarche, Yoan |4 aut | |
| 700 | 1 | |a Giasson, Marc |4 aut | |
| 700 | 1 | |a Rico, Philippe |4 aut | |
| 700 | 1 | |a Beaulieu, Yanick |4 aut | |
| 700 | 1 | |a Marsolais, Pierre |4 aut | |
| 700 | 1 | |a Serri, Karim |4 aut | |
| 700 | 1 | |a Bernard, Francis |4 aut | |
| 700 | 1 | |a Albert, Martin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Canadian journal of anesthesia |d New York, NY : Springer, 1954 |g 68(2020), 2 vom: 15. Sept., Seite 204-213 |w (DE-627)SPR026433923 |w (DE-600)2050416-0 |x 1496-8975 |7 nnns |
| 773 | 1 | 8 | |g volume:68 |g year:2020 |g number:2 |g day:15 |g month:09 |g pages:204-213 |
| 856 | 4 | 0 | |u https://dx.doi.org/10.1007/s12630-020-01816-z |z lizenzpflichtig |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_SPRINGER | ||
| 951 | |a AR | ||
| 952 | |d 68 |j 2020 |e 2 |b 15 |c 09 |h 204-213 | ||