Background: COVID-19 has spread rapidly worldwide. Many patients require mechanical ventilation. The goal of this study was to investigate the clinical course and outcomes of patients with COVID-19 undergoing mechanical ventilation and identify factors associated with death. Methods: Eighty-three consecutive critically ill patients with confirmed COVID-19 undergoing invasive mechanical ventilation were included in this retrospective, single-center, observational study from January 31 to March 15, 2020. Demographic, clinical, laboratory, radiological, and mechanical ventilation data were collected and analyzed. The primary outcome was 28-day mortality after endotracheal intubation. The secondary outcomes included the incidences of SARS-CoV-2-related cardiac, liver, and kidney injury. Results: Seventy-four out of 83 (89.2%) patients achieved oxygen saturation above 93% after intubation. Forty-nine out of 83 (59%) patients died and 34 (41%) patients survived after 28 days of observation. Multivariable regression showed increasing odds of death associated with cardiac injury (odds ratio 15.60, 95% CI 4.20–74.43), liver injury (5.40, 1.46–23.56), and kidney injury (8.39, 1.63–61.41), and decreasing odds of death associated with the higher PaO 2 /FiO 2 ratio before intubation (0.97, 0.95–0.99). PaO 2 /FiO 2 ratio before intubation demonstrated a positive linear correlation with platelet count ( r = 0.424, P = 0.001), and negative linear correlation with troponin I ( r = −0.395, P = 0.008). Conclusions: Cardiac, liver, and kidney injury may be associated with death for critically ill patients with COVID-19 undergoing invasive mechanical ventilation. The severity of pre-intubation hypoxia may be associated with a poorer outcome of patients with COVID-19 undergoing invasive mechanical ventilation. Larger, multi-institutional, prospective studies should be conducted to confirm these preliminary results.
【저자키워드】 COVID-19, SARS-CoV-2, outcomes, critically ill patients, Invasive mechanical ventilation, 【초록키워드】 mechanical ventilation, hypoxia, severity, Prospective Study, 28-day mortality, intubation, outcome, Laboratory, Kidney injury, Spread, oxygen saturation, Clinical course, Patient, death, Liver injury, Platelet, incidence, troponin I, correlation, demographic, liver, retrospective, cardiac, Injury, Odds ratio, Endotracheal intubation, observation, Critically ill patient, Factor, Primary outcome, 95% CI, Multivariable regression, single-center, secondary outcome, positive linear correlation, radiological, analyzed, identify, collected, conducted, linear, demonstrated, survived, PaO, patients died, patients with COVID-19, with COVID-19, 【제목키워드】 Wuhan, China, Mechanical,