Einstein (São Paulo) (Dec 2021)

Clinical characteristics and outcomes of COVID-19 patients admitted to the intensive care unit during the first year of the pandemic in Brazil: a single center retrospective cohort study

  • Thiago Domingos Corrêa,
  • Thais Dias Midega,
  • Karina Tavares Timenetsky,
  • Ricardo Luiz Cordioli,
  • Carmen Silvia Valente Barbas,
  • Moacyr Silva Júnior,
  • Bruno de Arruda Bravim,
  • Bruno Caldin Silva,
  • Gustavo Faissol Janot de Matos,
  • Ricardo Kenji Nawa,
  • Fabrício Rodrigues Torres de Carvalho,
  • Verônica Neves Fialho Queiroz,
  • Roberto Rabello Filho,
  • Felipe Maia de Toledo Piza,
  • Adriano José Pereira,
  • Marcele Liliane Pesavento,
  • Raquel Afonso Caserta Eid,
  • Bento Fortunato Cardoso dos Santos,
  • Andreia Pardini,
  • Vanessa Damázio Teich,
  • Claudia Regina Laselva,
  • Miguel Cendoroglo Neto,
  • Sidney Klajner,
  • Leonardo José Rolim Ferraz

DOI
https://doi.org/10.31744/einstein_journal/2021ao6739
Journal volume & issue
Vol. 19

Abstract

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ABSTRACT Objective: To describe clinical characteristics, resource use, outcomes, and to identify predictors of in-hospital mortality of patients with COVID-19 admitted to the intensive care unit. Methods: Retrospective single-center cohort study conducted at a private hospital in São Paulo (SP), Brazil. All consecutive adult (≥18 years) patients admitted to the intensive care unit, between March 4, 2020 and February 28, 2021 were included in this study. Patients were categorized between survivors and non-survivors according to hospital discharge. Results: During the study period, 1,296 patients [median (interquartile range) age: 66 (53-77) years] with COVID-19 were admitted to the intensive care unit. Out of those, 170 (13.6%) died at hospital (non-survivors) and 1,078 (86.4%) were discharged (survivors). Compared to survivors, non-survivors were older [80 (70-88) versus 63 (50-74) years; p<0.001], had a higher Simplified Acute Physiology Score 3 [59 (54-66) versus 47 (42-53) points; p<0.001], and presented comorbidities more frequently. During the intensive care unit stay, 56.6% of patients received noninvasive ventilation, 32.9% received mechanical ventilation, 31.3% used high flow nasal cannula, 11.7% received renal replacement therapy, and 1.5% used extracorporeal membrane oxygenation. Independent predictors of in-hospital mortality included age, Sequential Organ Failure Assessment score, Charlson Comorbidity Index, need for mechanical ventilation, high flow nasal cannula, renal replacement therapy, and extracorporeal membrane oxygenation support. Conclusion: Patients with severe COVID-19 admitted to the intensive care unit exhibited a considerable morbidity and mortality, demanding substantial organ support, and prolonged intensive care unit and hospital stay.

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