Abstract
An ongoing outbreak of pneumonia associated with severe acute respiratory coronavirus 2 (SARS-CoV-2) occurred at the end of February 2020 in Lombardy, Italy. We analyzed data from a retrospective, single-center case series of 310 consecutive patients, with confirmed SARS-CoV-2 infection, admitted to the emergency room. We aimed to describe the clinical course, treatment and outcome of a cohort of patients with COVID-19 pneumonia, with special attention to oxygen delivery and ventilator support. Throughout the study period, 310 consecutive patients, with confirmed SARS-CoV-2 infection, attended the Emergency Room (ER), of these, 34 were discharged home directly from the ER. Of the remaining 276 patients, the overall mortality was 30.4%: 7 patients died in the ER and 77 during hospitalization. With respect to oxygen delivery: 22 patients did not need any oxygen support (8.0%), 151 patients were treated with oxygen only (54.7%), and 49 (17.8%) were intubated. 90 patients (32.6%) were treated with CPAP (Continuous Positive Airway Pressure) or NIV (Non Invasive Ventilation); in this group, 27 patients had a Do Not Intubate (DNI) order and were treated with CPAP/NIV as an upper threshold therapy, showing high mortality rate (88.9%). Among the 63 patients treated with CPAP/NIV without DNI, NIV failure occurred in 36 patients (57.1%), with mortality rate of 47.2%. Twenty-seven (27) patients were treated with CPAP/NIV without needing mechanical ventilation and 26 were discharged alive (96.3%). The study documents the poor prognosis of patients with severe respiratory failure, although a considerable minority of patients treated with CPAP/NIV had a positive outcome.
Keywords: COVID-19; CPAP (continuous positive airway pressure); Epidemiology; NIV (non-invasive ventilation); SARS-CoV-2 infection.
【저자키워드】 COVID-19, Epidemiology, SARS-COV-2 infection, CPAP (continuous positive airway pressure), NIV (non-invasive ventilation), 【초록키워드】 Treatment, SARS-CoV-2, therapy, mechanical ventilation, Hospitalization, Pneumonia, SARS-COV-2 infection, severe respiratory failure, oxygen, outcome, Italy, airway, Clinical course, outbreak, Patient, mortality rate, threshold, patients, pressure, retrospective, CPAP, Emergency, lombardy, Support, Non-invasive, Intubated, ventilator, overall mortality, consecutive patients, poor prognosis, single-center, high mortality rate, oxygen support, positive, room, NIV, Respiratory Coronavirus, discharged home, analyzed, occurred, case sery, treated, discharged, cohort of patient, Continuous, DNI, oxygen only, patients died, patients treated, Throughout the study, with COVID-19, 【제목키워드】 Retrospective study, Characteristics, clinical, COVID-19 patients, Respiratory Support, single-center, diagnosed,