Lowell Ling1, Christina So2, Hoi Ping Shum3, Paul K S Chan4, Christopher K C Lai4, Darshana H Kandamby5, Eunise Ho5, Dominic So5, Wing Wa Yan3, Grace Lui6, Wai Shing Leung7, Man Chun Chan7, Charles D Gomersall8. 1. Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, China. lowell.ling@cuhk.edu.hk 2. Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Hong Kong, China. 3. Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China. 4. Department of Microbiology, The Chinese University of Hong Kong, Hong Kong, China. 5. Department of Intensive Care, Princess Margaret Hospital, Hong Kong, China. 6. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China. 7. Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China. 8. Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, China.
Abstract
Objective: To report the first eight cases of critically ill patients with coronavirus disease 2019 (COVID-19) in Hong Kong, describing the treatments and supportive care they received and their 28-day outcomes. Design: Multicentre retrospective observational cohort study. Setting: Three multidisciplinary intensive care units (ICUs) in Hong Kong. Participants: All adult critically ill patients with confirmed COVID-19 admitted to ICUs in Hong Kong between 22 January and 11 February 2020. Main outcome measure: 28-day mortality. Results: Eight out of 49 patients with COVID-19 (16%) were admitted to Hong Kong ICUs during the study period. The median age was 64.5 years (range, 42–70) with a median admission Sequential Organ Failure Assessment (SOFA) score of 6 (IQR, 4–7). Six patients (75%) required mechanical ventilation, six patients (75%) required vasopressors and two (25%) required renal replacement therapy. None of the patients required prone ventilation, nitric oxide or extracorporeal membrane oxygenation. The median times to shock reversal and extubation were 9 and 11 days respectively. At 28 days, one patient (12%) had died and the remaining seven (88%) all survived to ICU discharge. Only one of the survivors (14%) still required oxygen at 28 days. Conclusion: Critically ill patients with COVID-19 often require a moderate duration of mechanical ventilation and vasopressor support. Most of these patients recover and survive to ICU discharge with supportive care using lung protective ventilation strategies, avoiding excess fluids, screening and treating bacterial co-infection, and timely intubation. Lower rather than upper respiratory tract viral burden correlates with clinical severity of illness.
Objective: To report the first eight cases of critically illpatients with coronavirus disease 2019 (COVID-19) in Hong Kong, describing the treatments and supportive care they received and their 28-day outcomes. Design: Multicentre retrospective observational cohort study. Setting: Three multidisciplinary intensive care units (ICUs) in Hong Kong. Participants: All adult critically illpatients with confirmed COVID-19 admitted to ICUs in Hong Kong between 22 January and 11 February 2020. Main outcome measure: 28-day mortality. Results: Eight out of 49 patients with COVID-19 (16%) were admitted to Hong Kong ICUs during the study period. The median age was 64.5 years (range, 42–70) with a median admission Sequential Organ Failure Assessment (SOFA) score of 6 (IQR, 4–7). Six patients (75%) required mechanical ventilation, six patients (75%) required vasopressors and two (25%) required renal replacement therapy. None of the patients required prone ventilation, nitric oxide or extracorporeal membrane oxygenation. The median times to shock reversal and extubation were 9 and 11 days respectively. At 28 days, one patient (12%) had died and the remaining seven (88%) all survived to ICU discharge. Only one of the survivors (14%) still required oxygen at 28 days. Conclusion:Critically illpatients with COVID-19 often require a moderate duration of mechanical ventilation and vasopressor support. Most of these patients recover and survive to ICU discharge with supportive care using lung protective ventilation strategies, avoiding excess fluids, screening and treating bacterial co-infection, and timely intubation. Lower rather than upper respiratory tract viral burden correlates with clinical severity of illness.
Authors: Marcin F Osuchowski; Federico Aletti; Jean-Marc Cavaillon; Stefanie B Flohé; Evangelos J Giamarellos-Bourboulis; Markus Huber-Lang; Borna Relja; Tomasz Skirecki; Andrea Szabó; Marc Maegele Journal: Shock Date: 2020-10 Impact factor: 3.454
Authors: Monica Salerno; Francesco Sessa; Amalia Piscopo; Angelo Montana; Marco Torrisi; Federico Patanè; Paolo Murabito; Giovanni Li Volti; Cristoforo Pomara Journal: J Clin Med Date: 2020-05-14 Impact factor: 4.241