Characteristics of Patients with COVID-19 Pneumonia Admitted to the Intensive Care Unit and Predictors of Mortality in Wuhan, China: A Single-Centered Retrospective Cohort Study

Background: Coronavirus 2019 (COVID-19) first emerged in Wuhan, China in December 2019, but spread rapidly throughout the world and became a pandemic. Critically ill patients require admission to the intensive care unit (ICU) and were potentially life-threatened, but relevant data is scarce by now. Methods: A retrospective analysis of data were performed from all critically ill adult (>18 years old) patients admitted to the ICU of China-France New Town Branch of Tongji Hospital, Wuhan with COVID-19 pneumonia and determined outcomes between Feb 4, 2020 and Mar 12, 2020. Demographic data, symptoms, laboratory values, comorbidities, and clinical outcomes were all collected. Univariate and multivariate logistic regression methods were used to explore the predictors of in-hospital mortality. Findings: Sixty-nine ICU patients with COVID-19 pneumonia were included in the study, of whom 57 (83%) died and 12 (17%) recovered. Median age was 66.0 years, and male accounted for 46 (67%) of the patients. Forty patients (58%) had at least one comorbidity, with hypertension the most commonly seen. All patients had sepsis syndrome, and the median Sequential Organ Failure Assessment (SOFA) score was 6.0 (IQR 4.0-9.5). The median oxygenation index was 65.0 (IQR 53.0-94.0), and the median Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) score was 15.0 (IQR 11.0-20.5). Univariate analysis showed that older age, male, decreased oxygenation index, increased SOFA score, increased APACHE II score, increased lactic dehydrogenase, and increased high-sensitivity cardiac troponin I were predictors of mortality, but oxygenation index was the only independent predictor (OR 1.077, 95% CI 1.034-1.122) in multivariate analysis. Interpretation: COVID-19 pneumonia requiring admission to the ICU had a considerably high mortality rate. Many predictors are associated with mortality, but decreased oxygenation index is the main risk factor for death in these patients. Critically ill patients with a relatively high oxygenation index should be transferred to the ICU early to reach a favorable outcome. Funding Statement: This work is funded by the CAMS Innovation Fund for Medical Sciences (2018-12M-1-003). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study was approved by the Research Ethics Commission of Peking Union Medical College Hospital. Written informed consent was waived by the Ethics Commission for emerging infectious diseases and the retrospective nature.