Abstract
Objective: To describe the clinical and respiratory characteristics of a cohort of 43 patients with COVID-19 after an evolutive period of 28 days.
Design: A prospective, single-center observational study was carried out.
Setting: Intensive care.
Patients: Patients admitted due to COVID-19 and respiratory failure.
Interventions: None.
Variables: Automatic recording was made of demographic variables, severity parameters, laboratory data, assisted ventilation (HFO: high-flow oxygen therapy and IMV: invasive mechanical ventilation), oxygenation (PaO 2 , PaO 2 /FiO 2 ) and complications. The patients were divided into three groups: survivors (G1), deceased (G2) and patients remaining under admission (G3). The chi-squared test or Fisher exact test (categorical variables) was used, along with the Mann-Whitney U-test or Wilcoxon test for analyzing the differences between medians. Statistical significance was considered for p<0.05.
Results: A total of 43 patients were included (G1=28 [65.1%]; G2=10 [23.3%] and G3=5 [11.6%]), with a mean age of 65 years (range: 52-72), 62% males, APACHE II 18 (15-24), SOFA 6 (4-7). Arterial hypertension (30.2%) and obesity (25.6%) were the most frequent comorbidities. High-flow oxygen therapy was used in 62.7% of the patients, with failure in 85%. In turn, 95% of the patients required IMV and 85% received ventilation in prone decubitus. In the general population, initial PaO 2 /FiO 2 improved after 7 days (165 [125-210] vs.194 [153-285]; p=0.02), in the same way as in G1 (164 [125-197] vs. 207 [160-294]; p=0.07), but not in G2 (163 [95-197] vs. 135 [85-177]). No bacterial coinfection was observed. The incidence of IMV-associated pneumonia was high (13 episodes/1000 days of IMV).
Conclusions: Patients with COVID-19 require early IMV, a high frequency of ventilation in prone decubitus, and have a high incidence of failed HFO. The lack of improvement of PaO 2 /FiO 2 at 7 days could be a prognostic marker. .
Keywords: COVID-19; Insuficiencia respiratoria; Mechanical ventilation; Respiratory failure; Ventilación mecánica.
【저자키워드】 COVID-19, Respiratory failure, mechanical ventilation, Insuficiencia respiratoria, Ventilación mecánica, 【초록키워드】 Pneumonia, obesity, severity, Comorbidities, Ventilation, hypertension, Cohort, Characteristics, Patient, Oxygen therapy, Prognostic marker, complications, age, SOFA, General population, incidence, respiratory, Admission, Care, parameters, patients, Bacterial, Invasive mechanical ventilation, Frequency, Deceased, Demographic variables, APACHE II, Oxygenation, assisted ventilation, medians, laboratory data, single-center, Mann-Whitney, Fisher exact test, Wilcoxon test, survivor, high-flow oxygen therapy, arterial, IMV, males, initial, was used, lack, carried, the patient, required, turn, Automatic, HFO, Mechanical, PaO, patients with COVID-19, variables, with COVID-19, 【제목키워드】 pandemic, hospital, Infection, Patient, experience, the SARS-CoV-2, with COVID-19,