Outcomes of mechanically ventilated patients with COVID-19 associated respiratory failure.

Authors

• Christopher S King
• Dhwani Sahjwani
• A Whitney Brown
• Saad Feroz
• Paula Cameron
• Erik Osborn
• Mehul Desai
• Svetolik Djurkovic
• Aditya Kasarabada
• Rachel Hinerman
• James Lantry
• Oksana A Shlobin
• Kareem Ahmad
• Vikramjit Khangoora
• Shambhu Aryal
• A Claire Collins
• Alan Speir
• Steven Nathan

Publication/Presentation Date

1-1-2020

Abstract

PURPOSE: The outcomes of patients requiring invasive mechanical ventilation for COVID-19 remain poorly defined. We sought to determine clinical characteristics and outcomes of patients with COVID-19 managed with invasive mechanical ventilation in an appropriately resourced US health care system.

METHODS: Outcomes of COVID-19 infected patients requiring mechanical ventilation treated within the Inova Health System between March 5, 2020 and April 26, 2020 were evaluated through an electronic medical record review.

RESULTS: 1023 COVID-19 positive patients were admitted to the Inova Health System during the study period. Of these, 164 (16.0%) were managed with invasive mechanical ventilation. All patients were followed to definitive disposition. 70/164 patients (42.7%) had died and 94/164 (57.3%) were still alive. Deceased patients were older (median age of 66 vs. 55, p < 0.0001) and had a higher initial d-dimer (2.22 vs. 1.31, p = 0.005) and peak ferritin levels (2998 vs. 2077, p = 0.016) compared to survivors. 84.3% of patients over 70 years old died in the hospital. Conversely, 67.4% of patients age 70 or younger survived to hospital discharge. Younger age, non-Caucasian race and treatment at a tertiary care center were all associated with survivor status.

CONCLUSION: Mortality of patients with COVID-19 requiring invasive mechanical ventilation is high, with particularly daunting mortality seen in patients of advanced age, even in a well-resourced health care system. A substantial proportion of patients requiring invasive mechanical ventilation were not of advanced age, and this group had a reasonable chance for recovery.

Volume

15

Issue

11

First Page

0242651

Last Page

0242651

ISSN

1932-6203

Published In/Presented At

King, C. S., Sahjwani, D., Brown, A. W., Feroz, S., Cameron, P., Osborn, E., Desai, M., Djurkovic, S., Kasarabada, A., Hinerman, R., Lantry, J., Shlobin, O. A., Ahmad, K., Khangoora, V., Aryal, S., Collins, A. C., Speir, A., & Nathan, S. (2020). Outcomes of mechanically ventilated patients with COVID-19 associated respiratory failure. PloS one, 15(11), e0242651. https://doi.org/10.1371/journal.pone.0242651

Disciplines

Medicine and Health Sciences

PubMedID

33227024

Department(s)

Department of Medicine

Document Type

Article