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美国中西部一家三级医疗中心收治的重症新冠肺炎患者的管理与治疗结果

Management and outcomes of patients hospitalized with severe COVID-19 at a tertiary care center in midwestern United States.

作者信息

Gupta Sandeep, Kaushik Ashlesha, Gupta Jitendra

机构信息

Division of Pulmonary, Critical Care and Sleep Medicine, Unity Point Health at St. Luke's Regional Medical Center, Sioux City, IA.

Pediatric Infectious Diseases, Unity Point Health at St. Luke's Regional Medical Center, Sioux City, IA.

出版信息

Monaldi Arch Chest Dis. 2020 Oct 8;90(4). doi: 10.4081/monaldi.2020.1592.

Abstract

Knowledge of treatment regimens and outcomes for novel coronavirus disease 2019 (COVID-19) is evolving. Recent studies have reported mortality rates ranging from 39-50% among hospitalized patients with COVID-19. We report our experience ofmanagement and outcomes of hospitalized patients with COVID-19 at a large tertiary-care center in Midwestern United States. Of 658 patients presenting to our tertiary care center, 217 needed hospitalization, majority (77%) of whom were severely sick requiring admission to the intensive care unit (ICU). All received corticosteroids, and 78% of the patients received tocilizumab. More than two-thirds of the patients received anticoagulation and 80% of patients in the ICU had prone-positioning. The median duration of hospitalization was 12 days (interquartile range, 8 to16), median duration of intensive care unit stay was 7 days (interquartile range, 5 to 9) and requirement of mechanical ventilation was 6 days (interquartile range, 5 to 8) in our cohort. Of the 217 patients, 27 died (12% mortality). The majority of our patients received corticosteroids, tocilizumab, anticoagulation and prone positioning. While higher mortality rates of >30% have been reported in various studies among hospitalized patients with COVID-19, the majority of hospitalized patients in our cohort survived with a low mortality rate. The majority of our patients received corticosteroids, tocilizumab, anticoagulation and prone positioning. While higher mortality rates of >30% have been reported in various studies among hospitalized patients with COVID-19, the majority of hospitalized patients in our cohort survived with a low mortality rate.

摘要

关于2019年新型冠状病毒病(COVID-19)治疗方案和结果的认识正在不断发展。最近的研究报告称,COVID-19住院患者的死亡率在39%至50%之间。我们报告了美国中西部一家大型三级医疗中心对COVID-19住院患者的管理经验和结果。在658名到我们三级医疗中心就诊的患者中,217名需要住院治疗,其中大多数(77%)病情严重,需要入住重症监护病房(ICU)。所有患者均接受了皮质类固醇治疗,78%的患者接受了托珠单抗治疗。超过三分之二的患者接受了抗凝治疗,ICU中80%的患者采用了俯卧位通气。在我们的队列中,住院时间中位数为12天(四分位间距,8至16天),重症监护病房停留时间中位数为7天(四分位间距,5至9天),机械通气需求时间为6天(四分位间距,5至8天)。在这217名患者中,27人死亡(死亡率为12%)。我们的大多数患者接受了皮质类固醇、托珠单抗、抗凝治疗和俯卧位通气。虽然在各项研究中,COVID-19住院患者的死亡率报告高于30%,但我们队列中的大多数住院患者存活下来,死亡率较低。我们的大多数患者接受了皮质类固醇、托珠单抗、抗凝治疗和俯卧位通气。虽然在各项研究中,COVID-19住院患者的死亡率报告高于30%,但我们队列中的大多数住院患者存活下来,死亡率较低。

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