Patients with COVID-19 in 19 ICUs in Wuhan, China: a cross-sectional study

被引:132
作者
Yu, Yuan [1 ]
Xu, Dan [1 ]
Fu, Shouzhi [2 ]
Zhang, Jun [3 ]
Yang, Xiaobo [1 ]
Xu, Liang [4 ]
Xu, Jiqian [1 ]
Wu, Yongran [1 ]
Huang, Chaolin [5 ]
Ouyang, Yaqi [1 ]
Yang, Luyu [2 ]
Fang, Minghao [6 ]
Xiao, Hongwen [7 ]
Ma, Jing [8 ]
Zhu, Wei [9 ]
Hu, Song [10 ]
Hu, Quan [11 ]
Ding, Daoyin [11 ]
Hu, Ming [12 ]
Zhu, Guochao [13 ]
Xu, Weijiang [14 ]
Guo, Jun [15 ]
Xu, Jinglong [15 ]
Yuan, Haitao [16 ]
Zhang, Bin [17 ]
Yu, Zhui [18 ]
Chen, Dechang [19 ]
Yuan, Shiying [1 ]
Shang, You [1 ]
机构
[1] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Crit Care Med, Wuhan, Peoples R China
[2] Wuhan Third Hosp, Dept Intens Care Unit, Wuhan, Peoples R China
[3] Wuhan Hosp Tradit Chinese Med, Dept Crit Care Med, Wuhan, Peoples R China
[4] Wuhan Wuchang Hosp, Dept Crit Care Med, Wuhan, Peoples R China
[5] Jinyintan Hosp, Wuhan, Peoples R China
[6] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Emergency Internal Med, Wuhan, Peoples R China
[7] Xiehe Wuhan Red Cross Hosp, Intens Care Unit, Wuhan, Peoples R China
[8] Huazhong Univ Sci & Technol, Dept Intens Care Unit, Liyuan Hosp, Tongji Med Coll, Wuhan, Peoples R China
[9] Wuhan Univ Sci & Technol, Intens Care Unit, Tianyou Hosp, Wuhan, Peoples R China
[10] Fifth Hosp Wuhan, Intens Care Unit, Wuhan, Peoples R China
[11] First Peoples Hosp Jiangxia Dist, Intens Care Unit, Wuhan, Peoples R China
[12] Wuhan Pulm Hosp, Dept Crit Care Med, Wuhan, Peoples R China
[13] Jianghan Univ, Dept Crit Care Med, Affiliated Hosp, Wuhan, Peoples R China
[14] Huazhong Univ Sci & Technol, Cent Hosp Wuhan, Tongji Med Coll, Dept Crit Care Med, Wuhan, Peoples R China
[15] Huazhong Univ Sci & Technol, Union Jiangbei Hosp, Intens Care Unit, Wuhan, Peoples R China
[16] Dongxi Lake Dist Peoples Hosp, Intens Care Unit, Wuhan, Peoples R China
[17] Three Gorges Univ, Dept Intens Care Unit, Second Peoples Hosp, Yichang, Peoples R China
[18] Wuhan Univ, Dept Crit Care Med, Renmin Hosp, Wuhan, Peoples R China
[19] Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Crit Care Med, Sch Med, Shanghai, Peoples R China
关键词
COVID-19; Critically ill patients; Complications; Epidemic; RESPIRATORY-DISTRESS-SYNDROME;
D O I
10.1186/s13054-020-02939-x
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background A COVID-19 outbreak started in Wuhan, China, last December and now has become a global pandemic. The clinical information in caring of critically ill patients with COVID-19 needs to be shared timely, especially under the situations that there is still a largely ongoing spread of COVID-19 in many countries. Methods A multicenter prospective observational study investigated all the COVID-19 patients received in 19 ICUs of 16 hospitals in Wuhan, China, over 24 h between 8 AM February 2h and 8 AM February 27, 2020. The demographic information, clinical characteristics, vital signs, complications, laboratory values, and clinical managements of the patients were studied. Results A total of 226 patients were included. Their median (interquartile range, IQR) age was 64 (57-70) years, and 139 (61.5%) patients were male. The duration from the date of ICU admission to the study date was 11 (5-17) days, and the duration from onset of symptoms to the study date was 31 (24-36) days. Among all the patients, 155 (68.6%) had at least one coexisting disease, and their sequential organ failure assessment score was 4 (2-8). Organ function damages were found in most of the patients: ARDS in 161 (71.2%) patients, septic shock in 34 (15.0%) patients, acute kidney injury occurred in 57 (25.2%) patients, cardiac injury in 61 (27.0%) patients, and lymphocytopenia in 160 (70.8%) patients. Of all the studied patients, 85 (37.6%) received invasive mechanical ventilation, including 14 (6.2%) treated with extracorporeal membrane oxygenation (ECMO) at the same time, 20 (8.8%) received noninvasive mechanical ventilation, and 24 (10.6%) received continuous renal replacement therapy. By April 9, 2020, 87 (38.5%) patients were deceased and 15 (6.7%) were still in the hospital. Conclusions Critically ill patients with COVID-19 are associated with a higher risk of severe complications and need to receive an intensive level of treatments. COVID-19 poses a great strain on critical care resources in hospitals.
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