Bordon Jose, Akca Ozan, Furmanek Stephen, Cavallazzi Rodrigo Silva, Suliman Sally, Aboelnasr Amr, Sinanova Bettina, Ramirez Julio A
Washington Health Institute, Washington, DC 20017, USA.
Department of Medicine, George Washington University Medical Center, Washington, DC 20037, USA.
J Clin Med. 2021 Jun 30;10(13):2935. doi: 10.3390/jcm10132935.
Acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19) pneumonia is the main cause of the pandemic's death toll. The assessment of ARDS and time on invasive mechanical ventilation (IMV) could enhance the characterization of outcomes and management of this condition. This is a city-wide retrospective study of hospitalized patients with COVID-19 pneumonia from 5 March 2020 to 30 June 2020. Patients with critical illness were compared with those with non-critical illness. We examined the severity of ARDS and other factors associated with (i) weaning patients off IMV and (ii) mortality in a city-wide study in Louisville, KY. Of 522 patients with COVID-19 pneumonia, 219 (41.9%) were critically ill. Among critically ill patients, the median age was 60 years; 53% were male, 55% were White and 32% were African American. Of all critically ill patients, 52% had ARDS, and 38% of these had severe ARDS. Of the 25% of patients who were weaned off IMV, those with severe ARDS were weaned within eleven days versus five days for those without severe ARDS, = 0.023. The overall mortality for critically ill patients was 22% versus 1% for those not critically ill. Furthermore, the 14-day mortality was 31% for patients with severe ARDS and 12% for patients without severe ARDS, = 0.019. Patients with severe ARDS versus non-severe ARDS needed twice as long to wean off IMV (eleven versus five days) and had double the 14-day mortality of patients without severe ARDS.
2019冠状病毒病（COVID-19）肺炎所致的急性呼吸窘迫综合征（ARDS）是这场大流行造成死亡的主要原因。对ARDS及有创机械通气（IMV）时间的评估有助于更好地描述该病症的预后并指导治疗。这是一项对2020年3月5日至2020年6月30日期间因COVID-19肺炎住院患者进行的全市范围回顾性研究。将危重症患者与非危重症患者进行比较。我们在肯塔基州路易斯维尔市的一项全市范围研究中，考察了ARDS的严重程度以及与（i）使患者脱离IMV和（ii）死亡率相关的其他因素。在522例COVID-19肺炎患者中，219例（41.9%）为危重症患者。在危重症患者中，年龄中位数为60岁；53%为男性，55%为白人，32%为非裔美国人。在所有危重症患者中，52%患有ARDS，其中38%为重度ARDS。在脱离IMV的患者中，25%的重度ARDS患者在11天内脱离，而非重度ARDS患者为5天，P = 0.023。危重症患者的总体死亡率为22%，而非危重症患者为1%。此外，重度ARDS患者的14天死亡率为31%，非重度ARDS患者为12%，P = 0.019。重度ARDS患者与非重度ARDS患者相比，脱离IMV所需时间长两倍（11天对5天），14天死亡率是非重度ARDS患者的两倍。
