Clinical diagnosis, treatment and outcome of critically ill patients with coronavirus disease 2019 infected by SARS-CoV-2 in Wuhan and Shenyang, China: A dual-center, retrospective, observational study

Abstract

Background and Objective: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is currently circulating worldwide. Our purpose was to describe the clinical diagnosis, treatment and outcome of severe cases of SARS-CoV-2 infection. Methods: In this study, we collected 86 critically ill adult patients with COVID-19 treated in ICU of Wuhan Red Cross Hospital and the Sixth People’s Hospital of Shenyang from December 24, 2019 to February 10, 2021. Patients were divided into death group and survival group. The primary endpoint is the 28-day mortality rate, and the secondary endpoints were the incidence of acute respiratory distress syndrome (ARDS) and the proportion of patients requiring mechanical ventilation. Results: The average age of patients was 67.8 years, of whom 62 patients (72.1%) were male, 58 patients (67.4%) suffered from chronic diseases, and 84 patients (97.7%) had fever. The 28-day mortality rate was 53.5% (46/86 cases), and the average time from admission to ICU to clinical death was 7 days (IQR 3–11). There were 60 patients (69.7%) who occurred ARDS. There were 62 patients (72.1%) who required mechanical ventilation. And 37 patients (43.0%) received convalescent plasma treatment. Moreover, 30 patients (34.9%) were injected with tocilizumab. Conclusions: The mortality rate of critically ill patients with COVID-19 is high. The survival time of death cases is generally 1–2 weeks after entering the ICU. Old age, combined underlying diseases and ARDS are risk factors that increase the risk of death. Most critically ill patients require mechanical ventilation. Convalescent plasma and anti-IL-6 receptor monoclonal antibody may be effective immunotherapy methods.