What is it about?
In critically ill COVID-19 patients, it is a fact that respiration support saves lives, but reports from the United States, Canada, United Kingdom, and China have observed survival rates ranging from 15 to 97%, with the dissimilar signs and biochemical fluctuations possibly depending upon the variety of environmental factors and ethnicity. Given the need for better characterization of severe COVID-19 patients in our Italian context, the aim of this study is to describe albeit retrospectively the clinical and biochemical characteristics of the COVID-19 patients admitted to the intensive care unit (ICU) of our hospital.
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Why is it important?
We have presented the main clinical and biochemical features of 18 patients with severe COVID-19 that were managed in our ICU during the SARS-CoV-2 pandemic in Italy. The demographic descriptors were in line with the literature evidence, being older males the individuals more prone to both being infected and encountering severe consequences of COVID-19. In addition, we found the highest potential for casualty from nosocomial infections, meaning that the infectious cross-contamination affecting already critical patients, for example, surgical patients, could represent an exponential risk for fatal consequences.
Perspectives
Although our patients were relatively young individuals (mean age 67.77 ± 9.92 years), the incidence of mortality of 61.11% was higher than some previous reports, thus certainly contributing to reducing the ICU stay of non-survivors of 3 days less than the average survivors' length of stay. The great case fatality rate could be due to the co-existence of negative prognostic factors, such as polymorbidity, low BMI, and low hemoglobin. Furthermore, both the respiratory features (worsening of 72-h P/F) and the coagulation abnormalities (low antithrombin III) at admission could be indicative of an advanced stage of the disease. More information will be needed to inform intensive care for these challenging patients and therefore characterize both the unpredictable nature of SARS-CoV-2 and the multifaceted features of COVID-19.
Dr. M. Briguglio
IRCCS Ospedale Galeazzi - Sant'Ambrogio
Read the Original
This page is a summary of: Clinical Characteristics of Severe COVID-19 Patients Admitted to an Intensive Care Unit in Lombardy During the Italian Pandemic, Frontiers in Medicine, March 2021, Frontiers,
DOI: 10.3389/fmed.2021.582896.
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Resources
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The clinical efficacy of heparin in decreasing mortality rates in COVID-19 has been suggested by colleagues from China and United States of America, but they did not discuss the dose per patient.
Original study article
This is the paper that reported the original published article.
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