Anish R Mitra1, Nicholas A Fergusson1, Elisa Lloyd-Smith1, Andrew Wormsbecker1, Denise Foster1, Andrei Karpov1, Sarah Crowe1, Greg Haljan1, Dean R Chittock1, Hussein D Kanji1, Mypinder S Sekhon1, Donald E G Griesdale2. 1. Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC. 2. Division of Critical Care Medicine, Department of Medicine (Mitra, Wormsbecker, Foster, Karpov, Haljan, Chittock, Kanji, Sekhon, Griesdale), University of British Columbia, Vancouver, BC; Division of Critical Care Medicine, Department of Medicine (Mitra, Haljan), Surrey Memorial Hospital, Surrey, BC; MD Undergraduate Program (Fergusson), University of British Columbia; Quality & Patient Safety (Fergusson, Lloyd-Smith), Vancouver Coastal Health, Vancouver BC; Division of Critical Care Medicine, Department of Medicine (Wormsbecker), Royal Columbian Hospital, New Westminster, BC; Division of Critical Care Medicine, Department of Nurse Practitioners (Crowe), Surrey Memorial Hospital, Surrey, BC; Program of Critical Care (Chittock, Kanji, Sekhon, Griesdale), Vancouver General Hospital; Department of Anesthesiology, Pharmacology & Therapeutics (Griesdale), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Griesdale), Vancouver Coastal Health Research Institute, Vancouver, BC donald.griesdale@ubc.ca.
Abstract
BACKGROUND: Pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with high intensive care unit (ICU) mortality. We aimed to describe the clinical characteristics and outcomes of critically ill patients with coronavirus disease 2019 (COVID-19) in a Canadian setting. METHODS: We conducted a retrospective case series of critically ill patients with laboratory-confirmed SARS-CoV-2 infection consecutively admitted to 1 of 6 ICUs in Metro Vancouver, British Columbia, Canada, between Feb. 21 and Apr. 14, 2020. Demographic, management and outcome data were collected by review of patient charts and electronic medical records. RESULTS: Between Feb. 21 and Apr. 14, 2020, 117 patients were admitted to the ICU with a confirmed diagnosis of COVID-19. The median age was 69 (interquartile range [IQR] 60-75) years, and 38 (32.5%) were female. At least 1 comorbidity was present in 86 (73.5%) patients. Invasive mechanical ventilation was required in 74 (63.2%) patients. The duration of mechanical ventilation was 13.5 (IQR 8-22) days overall and 11 (IQR 6-16) days for patients successfully discharged from the ICU. Tocilizumab was administered to 4 patients and hydroxychloroquine to 1 patient. As of May 5, 2020, a total of 18 (15.4%) patients had died, 12 (10.3%) remained in the ICU, 16 (13.7%) were discharged from the ICU but remained in hospital, and 71 (60.7%) were discharged home. INTERPRETATION: In our setting, mortality in critically ill patients with COVID-19 admitted to the ICU was lower than in previously published studies. These data suggest that the prognosis associated with critical illness due to COVID-19 may not be as poor as previously reported.
BACKGROUND: Pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with high intensive care unit (ICU) mortality. We aimed to describe the clinical characteristics and outcomes of critically illpatients with coronavirus disease 2019 (COVID-19) in a Canadian setting. METHODS: We conducted a retrospective case series of critically illpatients with laboratory-confirmed SARS-CoV-2 infection consecutively admitted to 1 of 6 ICUs in Metro Vancouver, British Columbia, Canada, between Feb. 21 and Apr. 14, 2020. Demographic, management and outcome data were collected by review of patient charts and electronic medical records. RESULTS: Between Feb. 21 and Apr. 14, 2020, 117 patients were admitted to the ICU with a confirmed diagnosis of COVID-19. The median age was 69 (interquartile range [IQR] 60-75) years, and 38 (32.5%) were female. At least 1 comorbidity was present in 86 (73.5%) patients. Invasive mechanical ventilation was required in 74 (63.2%) patients. The duration of mechanical ventilation was 13.5 (IQR 8-22) days overall and 11 (IQR 6-16) days for patients successfully discharged from the ICU. Tocilizumab was administered to 4 patients and hydroxychloroquine to 1 patient. As of May 5, 2020, a total of 18 (15.4%) patients had died, 12 (10.3%) remained in the ICU, 16 (13.7%) were discharged from the ICU but remained in hospital, and 71 (60.7%) were discharged home. INTERPRETATION: In our setting, mortality in critically illpatients with COVID-19 admitted to the ICU was lower than in previously published studies. These data suggest that the prognosis associated with critical illness due to COVID-19 may not be as poor as previously reported.
Authors: Safiya Richardson; Jamie S Hirsch; Mangala Narasimhan; James M Crawford; Thomas McGinn; Karina W Davidson; Douglas P Barnaby; Lance B Becker; John D Chelico; Stuart L Cohen; Jennifer Cookingham; Kevin Coppa; Michael A Diefenbach; Andrew J Dominello; Joan Duer-Hefele; Louise Falzon; Jordan Gitlin; Negin Hajizadeh; Tiffany G Harvin; David A Hirschwerk; Eun Ji Kim; Zachary M Kozel; Lyndonna M Marrast; Jazmin N Mogavero; Gabrielle A Osorio; Michael Qiu; Theodoros P Zanos Journal: JAMA Date: 2020-05-26 Impact factor: 56.272
Authors: J L Vincent; R Moreno; J Takala; S Willatts; A De Mendonça; H Bruining; C K Reinhart; P M Suter; L G Thijs Journal: Intensive Care Med Date: 1996-07 Impact factor: 17.440
Authors: Giacomo Grasselli; Alberto Zangrillo; Alberto Zanella; Massimo Antonelli; Luca Cabrini; Antonio Castelli; Danilo Cereda; Antonio Coluccello; Giuseppe Foti; Roberto Fumagalli; Giorgio Iotti; Nicola Latronico; Luca Lorini; Stefano Merler; Giuseppe Natalini; Alessandra Piatti; Marco Vito Ranieri; Anna Mara Scandroglio; Enrico Storti; Maurizio Cecconi; Antonio Pesenti Journal: JAMA Date: 2020-04-28 Impact factor: 56.272
Authors: Pavan K Bhatraju; Bijan J Ghassemieh; Michelle Nichols; Richard Kim; Keith R Jerome; Arun K Nalla; Alexander L Greninger; Sudhakar Pipavath; Mark M Wurfel; Laura Evans; Patricia A Kritek; T Eoin West; Andrew Luks; Anthony Gerbino; Chris R Dale; Jason D Goldman; Shane O'Mahony; Carmen Mikacenic Journal: N Engl J Med Date: 2020-03-30 Impact factor: 91.245
Authors: Stephen Su Yang; Jed Lipes; Sandra Dial; Blair Schwartz; Denny Laporta; Evan Wong; Craig Baldry; Paul Warshawsky; Patricia McMillan; David Hornstein; Michel de Marchie; Dev Jayaraman Journal: CMAJ Open Date: 2020-11-24
Authors: Vionarica Gusti; Wan Jun Wu; Arpan Grover; Sabian Chiu; Kai-Wen Su; Erica Ma; Chanelle K Chow; Ella Sit; Jun Lim; Abhijit Pandhari; Mattias Park; Ryan Lee; Faisal Shahril; Shawn T Lim; Christopher Y Nguan; Dan Driedger; Avinash K Sinha; Ivan G Scrooby; Neilson J Mclean; Michael W Lee; Tyler D Yan; The Cosmic Team Journal: IEEE Open J Eng Med Biol Date: 2020-11-09
Authors: Amol A Verma; Tejasvi Hora; Hae Young Jung; Michael Fralick; Sarah L Malecki; Lauren Lapointe-Shaw; Adina Weinerman; Terence Tang; Janice L Kwan; Jessica J Liu; Shail Rawal; Timothy C Y Chan; Angela M Cheung; Laura C Rosella; Marzyeh Ghassemi; Margaret Herridge; Muhammad Mamdani; Fahad Razak Journal: CMAJ Date: 2021-06-07 Impact factor: 8.262