Rapid clinical evolution for COVID-19 translates into early hospital admission and unfavourable outcome: A preliminary report

Background: A wide range of mortality rates has been reported in COVID-19 patients on the intensive care unit We wanted to describe the clinical course and determine the mortality rate in our institution's intensive care units Methods: To this end, we performed a retrospective cohort study of 50 COVID-19 patients admitted to the ICU at a large German tertiary university hospital Clinical features are reported with a focus on ICU interventions, such as mechanical ventilation, prone positioning and extracorporeal organ support Outcome is presented using a 7-point ordinal scale on day 28 and 60 following ICU admission Results: The median age was 64 years, 78% were male LDH and D-Dimers were elevated, and patients were low on Vitamin D ARDS incidence was 75%, and 43/50 patients needed invasive ventilation 22/50 patients intermittently needed prone positioning, and 7/50 required ECMO The interval from onset of the first symptoms to admission to the hospital and to the ICU was shorter in non-survivors than in survivors By day 60 after ICU admission, 52% of the patients had been discharged 60-day mortality rate was 32%;37% for ventilated patients, and 42% for those requiring both: ventilation and renal replacement therapy Conclusions: Early deterioration might be seen as a warning signal for unfavourable outcome Lung-protective ventilation including prone positioning remain the mainstay of the treatment