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中国武汉 COVID-19 重症或危重症 ICU 患者的呼吸支持。

Respiratory Support in Severely or Critically Ill ICU Patients With COVID-19 in Wuhan, China.

机构信息

Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.

Department of Nephrology, General Hospital of the Yangtze River Shipping, Wuhan, 430010, China.

出版信息

Curr Med Sci. 2020 Aug;40(4):636-641. doi: 10.1007/s11596-020-2227-8. Epub 2020 Aug 29.

Abstract

This case series aimed to describe the clinical characteristics of severely or critically ill patients with COVID-19 and compare the clinical characteristics of patients who received invasive respiratory support with those of patients who received noninvasive respiratory support. We included all confirmed severe or critical illness cases of COVID-19 admitted to the Intensive Care Unit (ICU) of Zhongnan Hospital of Wuhan University, a COVID-19-designated hospital, from January 8 to March 12, 2020. Cases were analyzed for epidemiological, demographic, clinical, APACHE II, SOFA, radiological features and laboratory data. Outcomes of all patients were followed up as of March 12, 2020. This newly emerging virus had caused 55 confirmed severe or critical illness cases in ICU of a COVID-19-designated hospital. Most of the infected patients were men; more than half had underlying diseases, including hypertension, coronary artery disease and diabetes. The median age was 63 years old. Common symptoms at onset of illness were fever, fatigue and dry cough. Five (9.1%) hospitalized patients were presumed to have been infected in the hospital, and 4 (7.3%) health care workers were infected in their work. Of the 55 confirmed severe or critical illness cases, 10 (18.2%) patients died during the follow-up period as of March 12 with the median follow-up period of 28 days (interquartile range 16-35). Nine patients received VV-ECMO for severe respiratory failure and 4 (44.4%) patients died. Moreover, 28 patients received invasive respiratory support and 14 (50.0%) patients died. In this single-center study, 55 severely or critically ill ICU patients were confirmed to have COVID-19 in Wuhan and the overall mortality was 29.1%. Totally 28 (50.9%) of severely or critically ill ICU patients received invasive respiratory support and 14 (50.0%) died during the follow-up period.

摘要

本病例系列旨在描述 COVID-19 重症或危重症患者的临床特征,并比较接受有创性呼吸支持与接受无创性呼吸支持的患者的临床特征。我们纳入了 2020 年 1 月 8 日至 3 月 12 日期间武汉大学中南医院 COVID-19 指定医院 ICU 收治的所有确诊的 COVID-19 重症或危重症病例。对病例进行了流行病学、人口统计学、临床、APACHE II、SOFA、影像学特征和实验室数据的分析。截至 2020 年 3 月 12 日,对所有患者的结局进行了随访。这种新出现的病毒导致 COVID-19 指定医院 ICU 有 55 例确诊的重症或危重症病例。大多数感染患者为男性;超过一半的患者有基础疾病,包括高血压、冠心病和糖尿病。中位年龄为 63 岁。发病时常见的症状是发热、乏力和干咳。5 例(9.1%)住院患者被认为是在医院内感染,4 例(7.3%)医务人员在工作中感染。在 55 例确诊的重症或危重症病例中,截至 2020 年 3 月 12 日随访期间有 10 例(18.2%)患者死亡,中位随访期为 28 天(四分位距 16-35)。9 例患者因严重呼吸衰竭接受 VV-ECMO 治疗,其中 4 例(44.4%)死亡。此外,28 例患者接受了有创性呼吸支持,其中 14 例(50.0%)死亡。在这项单中心研究中,武汉共确诊 55 例 ICU 重症或危重症 COVID-19 患者,总体死亡率为 29.1%。共有 28 例(50.9%)重症或危重症 ICU 患者接受了有创性呼吸支持,在随访期间有 14 例(50.0%)死亡。

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