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

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World Journal of Critical Care Medicine 2021年第6期10卷 369-376页

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 Department of Hospital Medicine Covenant Health SystemKnoxvilleTNCovenant Health SystemKnoxvilleTX 37922United States Department of Medicine Morehouse School of MedicineAtlantaGA 30310United States Department of Cardiology Morehouse School of MedicineAtlantaGA 30310United States Department of Clinical Research Morehouse School of MedicineAtlantaGA 30310United States Department of Medicine Pulmonary and Critical Care SectionMorehouse School of MedicineAtlantaGA 30310United States

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.

关键词： COVID-19 COVID-19 surge Georgia Intensive care unit Mechanical ventilation

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