Intensive care unit hospitalizations and outcomes in patients with severe COVID-19 during summer and fall surges in Georgia

作     者：Titilope Olanipekun Temidayo Ayotomiwa Abe Valery Sammah Effoe Joffi E Musonge-Effoe Agusiegbe Chuks Esther Kwara Alexandra Caldwell Samed Obeng Nicolas Bakinde Gloria Westney Richard Snyder 

作者机构：Department of Hospital MedicineCovenant Health SystemKnoxvilleTNCovenant Health SystemKnoxvilleTX 37922United States Department of MedicineMorehouse School of MedicineAtlantaGA 30310United States Department of CardiologyMorehouse School of MedicineAtlantaGA 30310United States Department of Clinical ResearchMorehouse School of MedicineAtlantaGA 30310United States Department of MedicinePulmonary and Critical Care SectionMorehouse School of MedicineAtlantaGA 30310United States 

出 版 物：《World Journal of Critical Care Medicine》 (世界重症医学杂志)

年 卷 期：2021年第10卷第6期

页      面：369-376页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：COVID-19 COVID-19 surge Georgia Intensive care unit Mechanical ventilation 

摘      要：BACKGROUND There is limited data on the difference in the clinical characteristics and outcomes of patients with severe coronavirus disease 2019(COVID-19)infection in the summer compared to the fall *** To compare the sociodemographic,clinical characteristics,and outcomes among mechanically ventilated patients with severe COVID-19 infection admitted to the intensive care unit(ICU)during the summer and fall surges in the year *** We included patients admitted to the ICU and treated with invasive mechanical ventilation for COVID-19 associated respiratory failure between April 1 and December 31,*** were categorized into summer surge for ICU admissions between June 15,2020,and August 15,2020,and fall surge between October 15,2020,and December 31,*** compared patients characteristics and outcomes using descriptive and inferential *** A total of 220 patients were admitted to the Grady Memorial Hospital ICU and mechanically ventilated for COVID-19 associated hypoxemic respiratory failure during the period considered(125 during the summer surge and 95 during the fall surge).More women were admitted in the fall compared to summer(41.1%vs 36.8%,difference,4.3%;95%CI:1.2,7.5).Patients admitted in the fall had fewer comorbidities(chronic obstructive pulmonary disease,stroke,diabetes mellitus,obstructive sleep apnea and body mass index≥35 kg/m2).Overall,patients in the fall had a lower ICU mortality rate(27.4%vs 38.4%,difference,-11.0;95%CI:-6.4,-18.2),shorter length of stay on the mechanical ventilator(7 d vs 11 d,difference,4 d;95% CI:2.1,6.6)and shorter ICU length of stay(9 d vs 14 d,difference,5 d;95% CI:2.7,9.4).CONCLUSION Patients admitted with severe COVID-19 infection requiring mechanical ventilation had better outcomes in the fall than *** difference observed is likely attributable to a better understanding of the condition and advances in treatment strategies.