Critical Care for Patients with Severe Covid-2019 in Sichuan Province, China: Provincial Cohort Study
By
Xuelian Liao,
Hong Chen,
Bo Wang,
Zhen Li,
Zhongwei Zhang,
Weimin Li,
Zongan Liang,
Jin Tang,
Jian Wang,
Rui Shi,
Xiangde Zhen,
Maojuan Wang,
Xianying Lei,
Yu Gong,
Sheng Lv,
Chao Jia,
Li Chen,
Juan Shang,
Min Yang,
Hailong Wei,
Yuanjun Zhang,
Xiong Yang,
Huaqiang Shen,
Xianhua Xiao,
Jie Yang,
Qin Wu,
Wen Wang,
Jin Yang,
Chang Liu,
Wanhong Yin,
Xiaoqi Xie,
Yongming Tian,
Huan Liu,
Bingxing Shuai,
Wei Zhang,
Xiangrong Song,
Xiaodong Jin,
Yan Kang
Posted 27 Mar 2020
medRxiv DOI: 10.1101/2020.03.22.20041277
BackgroundData regarding critical care for patients with severe Covid-19 are limited. We aimed to describe the clinical course and critical care implemented for this patient population at the provincial level in Sichuan, China. MethodsIn this population-based multicenter cohort study, conducted from January 16 to March 15, 2020, all microbiologically confirmed Covid-19 patients who met the national severe or critical criteria were included and followed-up until discharge, death, or the end of the study. ResultsOut of 539 confirmed Covid-19 patients, 81 severe cases (15.0%) were identified. The median (IQR) age was 50 (39-65) years, 37% were female, and 53.1% had chronic comorbidities. Among the five predefined criteria for severe illness, low PaO2:FiO2 ratio (<300 mmHg), low pulse oxygen saturation ([≤]93%), and dyspnea were the most commonly reported, accounting for 87.7%, 66.7% and 27.2% of the severe cases, respectively. The median period from the onset of symptoms to the first hospitalization was 3 (1-6) days. Seventy-seven patients (95.06%) were admitted to hospitals being able to provide critical care by day 1. By day 28, 53 (65.4%) were discharged, 3 (3.7%) were deceased, and 25 (30.9%) were still hospitalized. Conventional oxygen therapy, administered to 95.1% of the patients, was the most commonly used respiratory support and met 62.7% of the respiratory support needed, followed by high-flow nasal cannula (19.5%) and noninvasive mechanical ventilation (10%). ConclusionsEarly identification, hospitalization, and provision of critical care to severe Covid-19 patients may improve prognosis. Sufficient conventional oxygen equipment should be prioritized and implemented without delay.
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