Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China
Abstract Background The global numbers of confirmed cases and deceased critically ill patients with COVID-19 are increasing. However, the clinical course, and the 60-day mortality and its predictors in critically ill patients have not been fully elucidated. The aim of this study is to identify the c...
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | Critical Care |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13054-020-03098-9 |
| _version_ | 1818839059462619136 |
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| author | Jiqian Xu Xiaobo Yang Luyu Yang Xiaojing Zou Yaxin Wang Yongran Wu Ting Zhou Yin Yuan Hong Qi Shouzhi Fu Hong Liu Jia’an Xia Zhengqin Xu Yuan Yu Ruiting Li Yaqi Ouyang Rui Wang Lehao Ren Yingying Hu Dan Xu Xin Zhao Shiying Yuan Dingyu Zhang You Shang |
| author_facet | Jiqian Xu Xiaobo Yang Luyu Yang Xiaojing Zou Yaxin Wang Yongran Wu Ting Zhou Yin Yuan Hong Qi Shouzhi Fu Hong Liu Jia’an Xia Zhengqin Xu Yuan Yu Ruiting Li Yaqi Ouyang Rui Wang Lehao Ren Yingying Hu Dan Xu Xin Zhao Shiying Yuan Dingyu Zhang You Shang |
| author_sort | Jiqian Xu |
| collection | DOAJ |
| description | Abstract Background The global numbers of confirmed cases and deceased critically ill patients with COVID-19 are increasing. However, the clinical course, and the 60-day mortality and its predictors in critically ill patients have not been fully elucidated. The aim of this study is to identify the clinical course, and 60-day mortality and its predictors in critically ill patients with COVID-19. Methods Critically ill adult patients admitted to intensive care units (ICUs) from 3 hospitals in Wuhan, China, were included. Data on demographic information, preexisting comorbidities, laboratory findings at ICU admission, treatments, clinical outcomes, and results of SARS-CoV-2 RNA tests and of serum SARS-CoV-2 IgM were collected including the duration between symptom onset and negative conversion of SARS-CoV-2 RNA. Results Of 1748 patients with COVID-19, 239 (13.7%) critically ill patients were included. Complications included acute respiratory distress syndrome (ARDS) in 164 (68.6%) patients, coagulopathy in 150 (62.7%) patients, acute cardiac injury in 103 (43.1%) patients, and acute kidney injury (AKI) in 119 (49.8%) patients, which occurred 15.5 days, 17 days, 18.5 days, and 19 days after the symptom onset, respectively. The median duration of the negative conversion of SARS-CoV-2 RNA was 30 (range 6–81) days in 49 critically ill survivors that were identified. A total of 147 (61.5%) patients deceased by 60 days after ICU admission. The median duration between ICU admission and decease was 12 (range 3–36). Cox proportional-hazards regression analysis revealed that age older than 65 years, thrombocytopenia at ICU admission, ARDS, and AKI independently predicted the 60-day mortality. Conclusions Severe complications are common and the 60-day mortality of critically ill patients with COVID-19 is considerably high. The duration of the negative conversion of SARS-CoV-2 RNA and its association with the severity of critically ill patients with COVID-19 should be seriously considered and further studied. |
| first_indexed | 2024-12-19T03:48:16Z |
| format | Article |
| id | doaj.art-753dc0d856ce4d81bf7c6621ebece107 |
| institution | Directory Open Access Journal |
| issn | 1364-8535 |
| language | English |
| last_indexed | 2024-12-19T03:48:16Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Critical Care |
| spelling | doaj.art-753dc0d856ce4d81bf7c6621ebece1072022-12-21T20:37:03ZengBMCCritical Care1364-85352020-07-0124111110.1186/s13054-020-03098-9Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, ChinaJiqian Xu0Xiaobo Yang1Luyu Yang2Xiaojing Zou3Yaxin Wang4Yongran Wu5Ting Zhou6Yin Yuan7Hong Qi8Shouzhi Fu9Hong Liu10Jia’an Xia11Zhengqin Xu12Yuan Yu13Ruiting Li14Yaqi Ouyang15Rui Wang16Lehao Ren17Yingying Hu18Dan Xu19Xin Zhao20Shiying Yuan21Dingyu Zhang22You Shang23Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of ICU/Emergency Wuhan Third Hospital, Wuhan UniversityDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of ICU/Emergency Wuhan Third Hospital, Wuhan UniversityDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyResearch Center for Translational Medicine, Jinyintan HospitalDepartment of Critical Care Medicine, Xiangyang No.1 Hospital, Affiliated Hospital of Hubei University of MedicineDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyResearch Center for Translational Medicine, Jinyintan HospitalDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background The global numbers of confirmed cases and deceased critically ill patients with COVID-19 are increasing. However, the clinical course, and the 60-day mortality and its predictors in critically ill patients have not been fully elucidated. The aim of this study is to identify the clinical course, and 60-day mortality and its predictors in critically ill patients with COVID-19. Methods Critically ill adult patients admitted to intensive care units (ICUs) from 3 hospitals in Wuhan, China, were included. Data on demographic information, preexisting comorbidities, laboratory findings at ICU admission, treatments, clinical outcomes, and results of SARS-CoV-2 RNA tests and of serum SARS-CoV-2 IgM were collected including the duration between symptom onset and negative conversion of SARS-CoV-2 RNA. Results Of 1748 patients with COVID-19, 239 (13.7%) critically ill patients were included. Complications included acute respiratory distress syndrome (ARDS) in 164 (68.6%) patients, coagulopathy in 150 (62.7%) patients, acute cardiac injury in 103 (43.1%) patients, and acute kidney injury (AKI) in 119 (49.8%) patients, which occurred 15.5 days, 17 days, 18.5 days, and 19 days after the symptom onset, respectively. The median duration of the negative conversion of SARS-CoV-2 RNA was 30 (range 6–81) days in 49 critically ill survivors that were identified. A total of 147 (61.5%) patients deceased by 60 days after ICU admission. The median duration between ICU admission and decease was 12 (range 3–36). Cox proportional-hazards regression analysis revealed that age older than 65 years, thrombocytopenia at ICU admission, ARDS, and AKI independently predicted the 60-day mortality. Conclusions Severe complications are common and the 60-day mortality of critically ill patients with COVID-19 is considerably high. The duration of the negative conversion of SARS-CoV-2 RNA and its association with the severity of critically ill patients with COVID-19 should be seriously considered and further studied.http://link.springer.com/article/10.1186/s13054-020-03098-9COVID-19MortalityThrombocytopeniaAcute respiratory syndromeAcute kidney injury |
| spellingShingle | Jiqian Xu Xiaobo Yang Luyu Yang Xiaojing Zou Yaxin Wang Yongran Wu Ting Zhou Yin Yuan Hong Qi Shouzhi Fu Hong Liu Jia’an Xia Zhengqin Xu Yuan Yu Ruiting Li Yaqi Ouyang Rui Wang Lehao Ren Yingying Hu Dan Xu Xin Zhao Shiying Yuan Dingyu Zhang You Shang Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China Critical Care COVID-19 Mortality Thrombocytopenia Acute respiratory syndrome Acute kidney injury |
| title | Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China |
| title_full | Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China |
| title_fullStr | Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China |
| title_full_unstemmed | Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China |
| title_short | Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China |
| title_sort | clinical course and predictors of 60 day mortality in 239 critically ill patients with covid 19 a multicenter retrospective study from wuhan china |
| topic | COVID-19 Mortality Thrombocytopenia Acute respiratory syndrome Acute kidney injury |
| url | http://link.springer.com/article/10.1186/s13054-020-03098-9 |
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