Critical Care for Severe COVID-19: A Population-based Study from a Province with Low Case-fatality Rate in China
ABSTRACT Background Data regarding critical care for patients with severe COVID-19 are limited. We aimed to describe the clinical course, multi-strategy management, and respiratory support usage for the severe COVID-19 at the provincial level.Methods Using data from Sichuan Provincial Department of Health and the multicentre cohort study, all microbiologically confirmed COVID-19 patients in Sichuan who met the national severe criteria were included and followed-up from the day of inclusion (D1), until discharge, death, or the end of the study.Findings Out of 539 COVID-19 patients, 81 severe cases (15.0%) were identified. The median (IQR) age was 50 (39-65) years, 37% were female, and 53.1% had chronic comorbidities. All severe cases were identified before requiring mechanical ventilation and treated in the intensive care units (ICUs), among whom 51 (63.0%) were treated in provisional ICUs and 77 patients (95.1%) were admitted by D1. On D1, 76 (93.8%) were administered by respiratory support, including 55 (67.9%) by conventional oxygen therapy (COT), 8 (9.9%) by high-flow nasal cannula (HFNC) and 13 (16.0%) by non-invasive ventilation (NIV). By D28, 53 (65.4%) were discharged, three (3.7%) were deceased, and 25 (30.9%) were still hospitalized. COT, administered to 95.1% of the patients, was the most commonly used respiratory support and met 62.7% of the respiratory support needed, followed by HFNC (19.3%), NIV ventilation (9.4%) and IV 8.5%.Interpretation The multi-strategy management for severe COVID-19 patients including early identification and timely critical care may contribute to the low case-fatailty. Preparation of sufficient conventional oxygen equipment should be prioritized.Trial registration number ChiCTR2000029758..
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Preprint| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
bioRxiv.org - (2020) vom: 01. Dez. Zur Gesamtaufnahme - year:2020 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Liao, Xuelian [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| doi: |
10.1101/2020.03.22.20041277 |
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| PPN (Katalog-ID): |
XBI000819999 |
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| 520 | |a ABSTRACT Background Data regarding critical care for patients with severe COVID-19 are limited. We aimed to describe the clinical course, multi-strategy management, and respiratory support usage for the severe COVID-19 at the provincial level.Methods Using data from Sichuan Provincial Department of Health and the multicentre cohort study, all microbiologically confirmed COVID-19 patients in Sichuan who met the national severe criteria were included and followed-up from the day of inclusion (D1), until discharge, death, or the end of the study.Findings Out of 539 COVID-19 patients, 81 severe cases (15.0%) were identified. The median (IQR) age was 50 (39-65) years, 37% were female, and 53.1% had chronic comorbidities. All severe cases were identified before requiring mechanical ventilation and treated in the intensive care units (ICUs), among whom 51 (63.0%) were treated in provisional ICUs and 77 patients (95.1%) were admitted by D1. On D1, 76 (93.8%) were administered by respiratory support, including 55 (67.9%) by conventional oxygen therapy (COT), 8 (9.9%) by high-flow nasal cannula (HFNC) and 13 (16.0%) by non-invasive ventilation (NIV). By D28, 53 (65.4%) were discharged, three (3.7%) were deceased, and 25 (30.9%) were still hospitalized. COT, administered to 95.1% of the patients, was the most commonly used respiratory support and met 62.7% of the respiratory support needed, followed by HFNC (19.3%), NIV ventilation (9.4%) and IV 8.5%.Interpretation The multi-strategy management for severe COVID-19 patients including early identification and timely critical care may contribute to the low case-fatailty. Preparation of sufficient conventional oxygen equipment should be prioritized.Trial registration number ChiCTR2000029758. | ||
| 700 | 1 | |a Chen, Hong |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Bo |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Zhen |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Zhongwei |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Weimin |e verfasserin |4 aut | |
| 700 | 1 | |a Liang, Zongan |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Jian |e verfasserin |4 aut | |
| 700 | 1 | |a Shi, Rui |e verfasserin |4 aut | |
| 700 | 1 | |a Zhen, Xiangde |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Maojuan |e verfasserin |4 aut | |
| 700 | 1 | |a Lei, Xianying |e verfasserin |4 aut | |
| 700 | 1 | |a Gong, Yu |e verfasserin |4 aut | |
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| 700 | 1 | |a Wei, Hailong |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Yuanjun |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Xiong |e verfasserin |4 aut | |
| 700 | 1 | |a Shen, Huaqiang |e verfasserin |4 aut | |
| 700 | 1 | |a Xiao, Xianhua |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Jie |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Chang |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Qin |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Wen |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Yin, Wanhong |e verfasserin |4 aut | |
| 700 | 1 | |a Xie, Xiaoqi |e verfasserin |4 aut | |
| 700 | 1 | |a Tian, Yongming |e verfasserin |4 aut | |
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| 700 | 1 | |a Kang, Yan |e verfasserin |4 aut | |
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