Departments of Medicine (Honarmand, Fiorini, Chakraborty, Gillett, Desai, Martin, Bosma, Slessarev, Ball, Mele, LeBlanc, Lazo-Langner, Nicholson, Arntfield, Basmaji), Medical Biophysics (Slessarev), Microbiology & Immunology and Division of Infectious Diseases (Elsayed), and Epidemiology and Biostatistics (Ball, Lazo-Langner), Western University, London, Ont.
CMAJ Open. 2022 Jul 19;10(3):E675-E684. doi: 10.9778/cmajo.20210151. Print 2022 Jul-Sep.
Characterizing the multiorgan manifestations and outcomes of patients hospitalized with COVID-19 will inform resource requirements to address the long-term burden of this disease. We conducted a descriptive analysis using prospectively collected data to describe the clinical characteristics and spectrum of organ dysfunction, and in-hospital and longer-term clinical outcomes of patients hospitalized with COVID-19 during the first wave of the pandemic at a Canadian centre.
We conducted a prospective case series involving adult patients (aged ≥ 18 yr) with COVID-19 admitted to 1 of 2 hospitals in London, Ontario, from Mar. 17 to June 18, 2020, during the first wave of the pandemic. We recorded patients' baseline characteristics, physiologic parameters, measures of organ function and therapies administered during hospitalization among patients in the intensive care unit (ICU) and in non-ICU settings, and compared the characteristics of hospital survivors and nonsurvivors. Finally, we recorded follow-up thoracic computed tomography (CT) and echocardiographic findings after hospital discharge.
We enrolled 100 consecutive patients (47 women) hospitalized with COVID-19, including 32 patients who received ICU care and 68 who received treatment in non-ICU settings. Respiratory sequelae were common: 23.0% received high-flow oxygen by nasal cannula, 9.0% received noninvasive ventilation, 24.0% received invasive mechanical ventilation and 2.0% received venovenous extracorporeal membrane oxygenation. Overall, 9.0% of patients had cerebrovascular events (3.0% ischemic stroke, 6.0% intracranial hemorrhage), and 6.0% had pulmonary embolism. After discharge, 11 of 19 patients had persistent abnormalities on CT thorax, and 6 of 15 had persistent cardiac dysfunction on echocardiography.
This study provides further evidence that COVID-19 is a multisystem disease involving neurologic, cardiac and thrombotic dysfunction, without evidence of hepatic dysfunction. Patients have persistent organ dysfunction after hospital discharge, underscoring the need for research on long-term outcomes of COVID-19 survivors.
描述因 COVID-19 住院患者的多器官表现和结局，可为解决该疾病的长期负担提供资源需求信息。我们使用前瞻性收集的数据进行描述性分析，以描述在加拿大中心 COVID-19 大流行第一波期间住院的 COVID-19 患者的临床特征和器官功能障碍谱，以及住院和更长期的临床结局。
我们进行了一项前瞻性病例系列研究，纳入 2020 年 3 月 17 日至 6 月 18 日期间在安大略省伦敦的 2 家医院之一因 COVID-19 住院的 100 例成年患者（年龄≥18 岁）。我们记录了患者的基线特征、生理参数、入住 ICU 和非 ICU 患者的器官功能和治疗措施，并比较了住院幸存者和非幸存者的特征。最后，我们记录了出院后的胸部计算机断层扫描（CT）和超声心动图结果。
我们纳入了 100 例连续 COVID-19 住院患者（47 例为女性），包括 32 例接受 ICU 治疗和 68 例接受非 ICU 治疗的患者。呼吸后遗症很常见：23.0%接受经鼻高流量氧疗，9.0%接受无创通气，24.0%接受有创机械通气，2.0%接受静脉-静脉体外膜肺氧合。总体而言，9.0%的患者有脑血管事件（3.0%缺血性卒中，6.0%颅内出血），6.0%有肺栓塞。出院后，19 例中有 11 例胸部 CT 持续异常，15 例中有 6 例超声心动图持续心功能障碍。
这项研究进一步证明 COVID-19 是一种多系统疾病，涉及神经系统、心脏和血栓功能障碍，没有肝功能障碍的证据。患者出院后仍有持续的器官功能障碍，这强调了需要对 COVID-19 幸存者的长期结局进行研究。
