Characteristics, interventions, and longer term outcomes of COVID-19 ICU patients in Denmark-A nationwide, observational study

被引:67
作者
Haase, Nicolai [1 ]
Plovsing, Ronni [2 ]
Christensen, Steffen [3 ]
Poulsen, Lone Musaeus [4 ]
Brochner, Anne Craveiro [5 ]
Rasmussen, Bodil Steen [6 ]
Helleberg, Marie [7 ]
Jensen, Jens Ulrik Staehr [8 ]
Andersen, Lars Peter Kloster [9 ]
Siegel, Hanna [10 ]
Ibsen, Michael [11 ]
Jorgensen, Vibeke [12 ]
Winding, Robert [13 ]
Iversen, Susanne [14 ]
Pedersen, Henrik Planck [15 ]
Madsen, Jacob [6 ]
Solling, Christoffer [16 ]
Garcia, Ricardo Sanchez [17 ]
Michelsen, Jens [18 ]
Mohr, Thomas [10 ]
Mannering, Anne [19 ]
Espelund, Ulrick Skipper [20 ]
Bundgaard, Helle [21 ]
Kirkegaard, Lynge [22 ]
Smitt, Margit [23 ]
Buck, David Levarett [24 ]
Ribergaard, Niels-Erik [25 ]
Pedersen, Helle Scharling [26 ]
Christensen, Birgitte Viebaek [27 ]
Perner, Anders [1 ]
机构
[1] Rigshosp, Dept Intens Care, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
[2] Hvidovre Univ Hosp, Dept Anesthesiol & Intens Care, Copenhagen, Denmark
[3] Arhus Univ Hosp, Dept Anesthesiol & Intens Care, Aarhus, Denmark
[4] Zealand Univ Hosp, Dept Anesthesiol & Intens Care, Koge, Denmark
[5] Kolding Cty Hosp, Dept Anesthesiol & Intens Care, Kolding, Denmark
[6] Alborg Univ Hosp, Dept Anesthesiol & Intens Care, Aalborg, Denmark
[7] Rigshosp, Dept Infect Dis, Copenhagen, Denmark
[8] Herlev Gentofte Hosp, Dept Resp Med, Copenhagen, Denmark
[9] Bispebjerg Hosp, Dept Anesthesiol & Intens Care, Copenhagen, Denmark
[10] Herlev Gentofte Hosp, Dept Anesthesiol & Intens Care, Copenhagen, Denmark
[11] North Zealand Hosp, Dept Anesthesiol & Intens Care, Hillerod, Denmark
[12] Rigshosp, Dept Cardiothorac Anesthesiol, Copenhagen, Denmark
[13] Herning Hosp, Dept Anesthesiol & Intens Care, Herning, Denmark
[14] Slagelse Hosp, Dept Anesthesiol & Intens Care, Slagelse, Denmark
[15] Zealand Univ Hosp, Dept Anesthesiol & Intens Care, Roskilde, Denmark
[16] Viborg Hosp, Dept Anesthesiol & Intens Care, Viborg, Denmark
[17] Esbjerg Cent Hosp, Dept Anesthesiol & Intens Care, Esbjerg, Denmark
[18] Odense Univ Hosp, Dept Anesthesiol & Intens Care, Odense, Denmark
[19] Svendborg Hosp, Dept Anesthesiol & Intens Care, Svendborg, Denmark
[20] Horsens Hosp, Dept Anesthesiol & Intens Care, Horsens, Denmark
[21] Randers Cent Hosp, Dept Anesthesiol & Intens Care, Randers, Denmark
[22] Abenra Hosp, Dept Anesthesiol & Intens Care, Abenra, Denmark
[23] Rigshosp, Dept Neuroanesthesiol, Copenhagen, Denmark
[24] Holbaek Cent Hosp, Dept Anesthesiol & Intens Care, Holbaek, Denmark
[25] Hjorring Hosp, Dept Anesthesiol & Intens Care, Hjorring, Denmark
[26] Nykobing Falster Hosp, Dept Anesthesiol & Intens Care, Nykobing, Denmark
[27] Glostrup Cty Hosp, Dept Anesthesiol & Intens Care, Copenhagen, Denmark
关键词
comorbidities; COVID-19; intensive care; mortality; SARS-CoV-2; EXPOSURE;
D O I
10.1111/aas.13701
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background Most data on intensive care unit (ICU) patients with COVID-19 originate in selected populations from stressed healthcare systems with shorter term follow-up. We present characteristics, interventions and longer term outcomes of the entire, unselected cohort of all ICU patients with COVID-19 in Denmark where the ICU capacity was not exceeded. Methods We identified all patients with SARS-CoV-2 admitted to any Danish ICU from 10 March to 19 May 2020 and registered demographics, chronic comorbidities, use of organ support, length of stay, and vital status from patient files. Risk factors for death were analyzed using adjusted Cox regression analysis. Results There were 323 ICU patients with confirmed COVID-19. Median age was 68 years, 74% were men, 50% had hypertension, 21% diabetes, and 20% chronic pulmonary disease; 29% had no chronic comorbidity. Invasive mechanical ventilation was used in 82%, vasopressors in 83%, renal replacement therapy in 26%, and extra corporeal membrane oxygenation in 8%. ICU stay was median 13 days (IQR 6-22) and hospital stay 19 days (11-30). Median follow-up was 79 days. At end of follow-up, 118 had died (37%), 15 (4%) were still in hospital hereof 4 in ICU as of 16 June 2020. Risk factors for mortality included male gender, age, chronic pulmonary disease, active cancer, and number of co-morbidities. Conclusions In this nationwide, population-based cohort of ICU patients with COVID-19, longer term survival was high despite high age and substantial use of organ support. Male gender, age, and chronic co-morbidities, in particular chronic pulmonary disease, were associated with increased risk of death.
引用
收藏
页码:68 / 75
页数:8
相关论文
共 18 条
[1]  
AABY P, 1988, REV INFECT DIS, V10, P452
[2]   Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State [J].
Arentz, Matt ;
Yim, Eric ;
Klaff, Lindy ;
Lokhandwala, Sharukh ;
Riedo, Francis X. ;
Chong, Maria ;
Lee, Melissa .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2020, 323 (16) :1612-1614
[3]   Association of Age With Short-term and Long-term Mortality Among Patients Discharged From Intensive Care Units in France [J].
Atramont, Alice ;
Lindecker-Cournil, Valerie ;
Rudant, Jeremie ;
Tajahmady, Ayden ;
Drewniak, Nicolas ;
Fouard, Annie ;
Singer, Mervyn ;
Leone, Marc ;
Legrand, Matthieu .
JAMA NETWORK OPEN, 2019, 2 (05)
[4]   Effect of Lung Recruitment and Titrated Positive End-Expiratory Pressure (PEEP) vs Low PEEP on Mortality in Patients With Acute Respiratory Distress Syndrome A Randomized Clinical Trial [J].
Cavalcanti, Alexandre Biasi ;
Suzumura, Erica Aranha ;
Laranjeira, Ligia Nasi ;
Paisani, Denise de Moraes ;
Damiani, Lucas Petri ;
Guimaraes, Helio Penna ;
Romano, Edson Renato ;
Regenga, Marisa de Moraes ;
Taniguchi, Luzia Noriko Takahashi ;
Teixeira, Cassiano ;
de Oliveira, Roselaine Pinheiro ;
Machado, Flavia Ribeiro ;
Diaz-Quijano, Fredi Alexander ;
de Alencar Filho, Meton Soares ;
Maia, Israel Silva ;
Caser, Eliana Bernardete ;
de Oliveira Filho, Wilson ;
Borges, Marcos de Carvalho ;
Martins, Priscilla de Aquino ;
Matsui, Mirna ;
Ospina-Tascon, Gustavo Adolfo ;
Giancursi, Thiago Simoes ;
Giraldo-Rarnirez, Nelson Dario ;
Rios Vieira, Silvia Regina ;
Pasquotto de Lima Assef, Maria da Graca ;
Hasan, Mohd Shahnaz ;
Szczeklik, Wojciech ;
Rios, Fernando ;
Amato, Marcelo Britto Passos ;
Berwanger, Otavio ;
Ribeiro de Carvalho, Carlos Roberto .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2017, 318 (14) :1335-1345
[5]   Features of 20133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study [J].
Docherty, Annemarie B. ;
Harrison, Ewen M. ;
Green, Christopher A. ;
Hardwick, Hayley E. ;
Pius, Riinu ;
Norman, Lisa ;
Holden, Karl A. ;
Read, Jonathan M. ;
Dondelinger, Frank ;
Carson, Gail ;
Merson, Laura ;
Lee, James ;
Plotkin, Daniel ;
Sigfrid, Louise ;
Halpin, Sophie ;
Jackson, Clare ;
Gamble, Carrol ;
Horby, Peter W. ;
Nguyen-Van-Tam, Jonathan S. ;
Ho, Antonia ;
Russell, Clark D. ;
Dunning, Jake ;
Openshaw, Peter Jm ;
Baillie, J. Kenneth ;
Semple, Malcolm G. .
BMJ-BRITISH MEDICAL JOURNAL, 2020, 369
[6]   Genomewide Association Study of Severe Covid-19 with Respiratory Failure [J].
Ellinghaus, David ;
Degenhardt, Frauke ;
Bujanda, Luis ;
Buti, Maria ;
Albillos, Agustin ;
Invernizzi, Pietro ;
Fernandez, Javier ;
Prati, Daniele ;
Baselli, Guido ;
Asselta, Rosanna ;
Grimsrud, Marit M. ;
Milani, Chiara ;
Aziz, Fatima ;
Kassens, Jan ;
May, Sandra ;
Wendorff, Mareike ;
Wienbrandt, Lars ;
Uellendahl-Werth, Florian ;
Zheng, Tenghao ;
Yi, Xiaoli ;
de Pablo, Raul ;
Chercoles, Adolfo G. ;
Palom, Adriana ;
Garcia-Fernandez, Alba-Estela ;
Rodriguez-Frias, Francisco ;
Zanella, Alberto ;
Bandera, Alessandra ;
Protti, Alessandro ;
Aghemo, Alessio ;
Lleo, Ana ;
Biondi, Andrea ;
Caballero-Garralda, Andrea ;
Gori, Andrea ;
Tanck, Anja ;
Nolla, Anna Carreras ;
Latiano, Anna ;
Fracanzani, Anna Ludovica ;
Peschuck, Anna ;
Julia, Antonio ;
Pesenti, Antonio ;
Voza, Antonio ;
Jimenez, David ;
Mateos, Beatriz ;
Jimenez, Beatriz Nafria ;
Quereda, Carmen ;
Paccapelo, Cinzia ;
Gassner, Christoph ;
Angelini, Claudio ;
Cea, Cristina ;
Solier, Aurora .
NEW ENGLAND JOURNAL OF MEDICINE, 2020, 383 (16) :1522-1534
[7]   Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy Early Experience and Forecast During an Emergency Response [J].
Grasselli, Giacomo ;
Pesenti, Antonio ;
Cecconi, Maurizio .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2020, 323 (16) :1545-1546
[8]   Clinical Characteristics of Coronavirus Disease 2019 in China [J].
Guan, W. ;
Ni, Z. ;
Hu, Yu ;
Liang, W. ;
Ou, C. ;
He, J. ;
Liu, L. ;
Shan, H. ;
Lei, C. ;
Hui, D. S. C. ;
Du, B. ;
Li, L. ;
Zeng, G. ;
Yuen, K. -Y. ;
Chen, R. ;
Tang, C. ;
Wang, T. ;
Chen, P. ;
Xiang, J. ;
Li, S. ;
Wang, Jin-lin ;
Liang, Z. ;
Peng, Y. ;
Wei, L. ;
Liu, Y. ;
Hu, Ya-hua ;
Peng, P. ;
Wang, Jian-ming ;
Liu, J. ;
Chen, Z. ;
Li, G. ;
Zheng, Z. ;
Qiu, S. ;
Luo, J. ;
Ye, C. ;
Zhu, S. ;
Zhong, N. .
NEW ENGLAND JOURNAL OF MEDICINE, 2020, 382 (18) :1708-1720
[9]   Severe COVID-19 is associated with deep and sustained multifaceted cellular immunosuppression [J].
Jeannet, Robin ;
Daix, Thomas ;
Formento, Remy ;
Feuillard, Jean ;
Francois, Bruno .
INTENSIVE CARE MEDICINE, 2020, 46 (09) :1769-1771
[10]  
Nielsen NM, 2001, SCAND J INFECT DIS, V33, P301, DOI 10.1080/003655401300077360