Pande Dimple, Kochhar Anjali, Saini Suman, Ganapathy Usha, Gogia Anoop Raj
Department of Anaesthesia and Critical Care, VMMC and Safdarjung Hospital, New Delhi, India.
Indian J Palliat Care. 2020 Jun;26(Suppl 1):S36-S39. doi: 10.4103/IJPC.IJPC_146_20. Epub 2020 Jun 30.
Coronavirus disease 2019 (COVID-19) has become a global pandemic with the spectrum of disease from asymptomatic or mild disease to severe cases requiring intensive care unit (ICU) admission. In India, it started with milder presentation affecting younger population. Later on, an increase in disease severity was observed involving older age group as well. However, there is a paucity of published data regarding patients requiring ICU care in India. This case series describes the initial experience of an ICU in India regarding epidemiological profile, clinical course, and outcome of critically ill COVID-19 patients.
This case series included 27 consecutive laboratory-confirmed COVID-19 patients who were admitted in a tertiary care ICU over 14 days period, followed up till their discharge from ICU. Demographic and clinical data, including laboratory and radiological findings, were compiled with special attention to co-morbidities of the patients. The management of these patients was done as per the institutional protocol for critically ill COVID-19 patients.
The median age of the patients was 50 years with no difference in gender. Comorbid conditions were seen in 85% of the patients with diabetes (43.7%) and hypertension (37.5%) as the most common conditions. The median duration of symptoms before admission was 6 days with fever as the most common clinical symptom at presentation. Chest roentogram showed bilateral lung infiltrates in 88.8% of the patients. Mild, moderate, and severe hypoxia were observed in 3, 8, and 16 patients, respectively. Ten patients were managed with oxygen therapy. Seventeen patients (62.9%) required ventilatory support. Mortality rate among patients admitted to our ICU was 59.2%.
This case series shows middle-aged patients with comorbid diseases present with severe COVID-19 disease and have poor outcome.
2019冠状病毒病(COVID-19)已成为全球大流行疾病,其疾病谱涵盖无症状或轻症病例至需要入住重症监护病房(ICU)的重症病例。在印度,起初该病表现较为温和,主要影响年轻人群。后来,也观察到疾病严重程度有所增加,涉及老年人群体。然而,关于印度需要ICU护理的患者的已发表数据较少。本病例系列描述了印度一家ICU对危重症COVID-19患者的流行病学特征、临床病程及转归的初步经验。
本病例系列纳入了连续27例实验室确诊的COVID-19患者,这些患者在14天内入住一家三级护理ICU,并随访至其从ICU出院。收集了人口统计学和临床数据,包括实验室和影像学检查结果,特别关注患者的合并症。这些患者按照针对危重症COVID-19患者的机构方案进行管理。
患者的中位年龄为50岁,性别无差异。85%的患者有合并症,其中糖尿病(43.7%)和高血压(37.5%)最为常见。入院前症状的中位持续时间为6天,发热是最常见的临床表现。胸部X线片显示88.8%的患者双侧肺部有浸润。分别有3例、8例和16例患者出现轻度、中度和重度缺氧。10例患者接受了氧疗。17例患者(62.9%)需要机械通气支持。入住我们ICU的患者死亡率为59.2%。
本病例系列表明,患有合并症的中年患者感染COVID-19后病情严重,预后较差。