Department of Anesthesia and Critical Care, Kobe City Medical Center General Hospital, 2-1-1, Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
Department of Emergency Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
J Anesth. 2021 Apr;35(2):213-221. doi: 10.1007/s00540-021-02897-w. Epub 2021 Jan 23.
Coronavirus disease 2019 (COVID-19) has placed a great burden on critical care services worldwide. Data regarding critically ill COVID-19 patients and their demand of critical care services outside of initial COVID-19 epicenters are lacking. This study described clinical characteristics and outcomes of critically ill COVID-19 patients and the capacity of a COVID-19-dedicated intensive care unit (ICU) in Kobe, Japan.
This retrospective observational study included critically ill COVID-19 patients admitted to a 14-bed COVID-19-dedicated ICU in Kobe between March 3, 2020 and June 21, 2020. Clinical and daily ICU occupancy data were obtained from electrical medical records. The last follow-up day was June 28, 2020.
Of 32 patients included, the median hospital follow-up period was 27 (interquartile range 19-50) days. The median age was 68 (57-76) years; 23 (72%) were men and 25 (78%) had at least one comorbidity. Nineteen (59%) patients received invasive mechanical ventilation for a median duration of 14 (8-27) days. Until all patients were discharged from the ICU on June 5, 2020, the median daily ICU occupancy was 50% (36-71%). As of June 28, 2020, six (19%) died during hospitalization. Of 26 (81%) survivors, 23 (72%) were discharged from the hospital and three (9%) remained in the hospital.
During the first months of the outbreak in Kobe, most critically ill patients were men aged ≥ 60 years with at least one comorbidity and on mechanical ventilation; the ICU capacity was not strained, and the case-fatality rate was 19%.
2019 年冠状病毒病（COVID-19）给全球重症监护服务带来了巨大负担。缺乏关于 COVID-19 重症患者及其在 COVID-19 最初中心以外对重症监护服务需求的数据。本研究描述了日本神户 COVID-19 专用重症监护病房（ICU）中 COVID-19 重症患者的临床特征和结局以及该 ICU 的容量。
这是一项回顾性观察性研究，纳入了 2020 年 3 月 3 日至 6 月 21 日期间入住神户 14 张床位 COVID-19 专用 ICU 的 COVID-19 重症患者。从电子病历中获得临床和每日 ICU 入住数据。最后随访日为 2020 年 6 月 28 日。
在纳入的 32 例患者中，中位住院随访期为 27（四分位间距 19-50）天。中位年龄为 68（57-76）岁；23 例（72%）为男性，25 例（78%）至少有一种合并症。19 例（59%）患者接受了中位持续时间为 14（8-27）天的有创机械通气。截至 2020 年 6 月 5 日所有患者从 ICU 出院时，中位每日 ICU 入住率为 50%（36-71%）。截至 2020 年 6 月 28 日，6 例（19%）住院期间死亡。26 例（81%）幸存者中，23 例（72%）出院，3 例（9%）仍住院。
在神户 COVID-19 爆发的最初几个月中，大多数 COVID-19 重症患者为年龄≥60 岁、至少有一种合并症且正在接受机械通气的男性；ICU 容量未受压力，病死率为 19%。
