Respiratory failure in patients with COVID-19: our experience during the second wave

Abstract

Objective: To report the management and outcome of 64 patients admitted to the ICU during the second wave of COVID-19 covering a period of 90 days.

Design: Case series, prospective, observational, descriptive study.

Setting: Adult ICU.

Patients: With COVID-19 admitted to the ICU due to respiratory failure.

Variables of interest: Age, sex, APACHE II score, requirement of mechanical ventilation, prone position, neuromuscular blockade, vasopressors, renal replacement therapy, ventilator-associated pneumonia, pulmonary thromboembolism, multiple organ dysfunction.

Results: From a cohort of 95 admitted patients, 64 had a positive COVID-19 test. They were divided into two groups: survival group and non-survival group. The average age was 57 (male 68.75%). 92.10% required mechanical ventilation (median 10 days), without a significant difference between groups. 50% required the prone position, without significant difference between groups, but the survival group had more prone cycles. 81.30% required neuromuscular blockade. A high level of ventilator-associated pneumonia was observed (56.04%): 34.6% due to Klebsiella pneumoniae (KPC) and 42% of multiple organ dysfunction (p 0.0097). The initial APACHE II score was 15 (p 0.0013). The mortality rate was 68.8%.

Conclusions: Mortality rate was higher in groups with acute respiratory distress syndrome especially in males and in older patients. The most frequent complications were ventilation-associated pneumonia and multiple organ dysfunction.