Cent Eur J Public Health 2021, 29(1):3-8 | DOI: 10.21101/cejph.a6672

COVID-19 severe pneumonia: Prospective multicentre study on demands on intensive care capacities

Olga Džupová1, Michal Moravec2, Hynek Bartoš3, Peter Brestovanský4, Tomáš Tencer5, Tomáš Hyánek6, Jan Beroušek7, Zdeňka Krupková8, František Mošna9, Tomáš Vymazal7, Jiří Beneš1
1 Third Faculty of Medicine, Charles University, and Department of Infectious Diseases, Hospital Na Bulovce, Prague, Czech Republic
2 First Faculty of Medicine, Charles University, and Department of Anaesthesiology and Critical Care, Thomayer Hospital, Prague, Czech Republic
3 Third Faculty of Medicine, Charles University, and Department of Infectious Diseases, Masaryk Hospital, Ústí nad Labem, Czech Republic
4 First Faculty of Medicine, Charles University, and Department of Anaesthesiology, Resuscitation and Intensive Medicine, General University Hospital, Prague, Czech Republic
5 Third Faculty of Medicine, Charles University, and Department of Anaesthesiology, Resuscitation and Intensive Medicine, University Hospital Královské Vinohrady, Prague, Czech Republic
6 Department of Anaesthesiology and Reanimation, Hospital Na Homolce, Prague, Czech Republic
7 Second Faculty of Medicine, Charles University, and Department of Anaesthesiology, Resuscitation and Intensive Medicine, Motol University Hospital, Prague, Czech Republic
8 Department of Anaesthesiology and Resuscitation, Hospital Na Bulovce, Prague, Czech Republic
9 Second Faculty of Medicine, Charles University, and Department of Cardiology, Motol University Hospital, Prague, Czech Republic

Objectives: The aim of the study was to obtain data on demands on the intensive care capacities to treat COVID-19 patients, and to identify predictors for in-hospital mortality.

Methods: The prospective observational multicentre study carried out from 1 March till 30 June 2020 included adult patients with confirmed SARS-CoV-2 infection with respiratory failure requiring ventilatory support or high-flow nasal oxygen therapy (HFNO).

Results: Seventy-four patients, 46 males and 28 females, median age 67.5 (Q1-Q3: 56-75) years, were included. Sixty-four patients (86.5%) had comorbidity. Sixty-six patients (89.2%) were mechanically ventilated, four of them received extracorporeal membrane oxygenation therapy. Eight patients (10.8%) were treated with non-invasive ventilation and HFNO only. The median of intensive care unit (ICU) stay was 22.5 days. Eighteen patients (24.3%) needed continuous renal replacement therapy. Thirty patients (40.5%) died. Age and acute kidney injury were identified as independent predictors of in-hospital death, and chronic kidney disease showed trend towards statistical significance for poor outcome.

Conclusions: Sufficient number of intensive care beds, organ support equipment and well-trained staff is a decisive factor in managing the COVID-19 epidemic. The study focused on the needs of intensive care in the COVID-19 patients. Advanced age and acute kidney injury were identified as independent predictors for in-hospital mortality. When compared to clinical course and ICU management of patients with severe community-acquired pneumonia caused by other pathogens, we observed prolonged need for ventilatory support, high rate of progression to acute respiratory distress syndrome and significant mortality in studied population.

Klíčová slova: COVID-19, respiratory failure, kidney disease, intensive care, mortality

Vloženo: 14. prosinec 2020; Revidováno: 5. březen 2021; Přijato: 5. březen 2021; Zveřejněno: 31. březen 2021  Zobrazit citaci

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Džupová O, Moravec M, Bartoš H, Brestovanský P, Tencer T, Hyánek T, et al.. COVID-19 severe pneumonia: Prospective multicentre study on demands on intensive care capacities. Cent Eur J Public Health. 2021;29(1):3-8. doi: 10.21101/cejph.a6672. PubMed PMID: 33831279.
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