ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019

Crit Care Med. 2020 May 26;10.1097/CCM.0000000000004457. doi: 10.1097/CCM.0000000000004457. Online ahead of print.

Abstract

Objectives: To determine mortality rates among adults with critical illness from coronavirus disease 2019.

Design: Observational cohort study of patients admitted from March 6, 2020, to April 17, 2020.

Setting: Six coronavirus disease 2019 designated ICUs at three hospitals within an academic health center network in Atlanta, Georgia, United States.

Patients: Adults greater than or equal to 18 years old with confirmed severe acute respiratory syndrome-CoV-2 disease who were admitted to an ICU during the study period.

Interventions: None.

Measurements and main results: Among 217 critically ill patients, mortality for those who required mechanical ventilation was 35.7% (59/165), with 4.8% of patients (8/165) still on the ventilator at the time of this report. Overall mortality to date in this critically ill cohort is 30.9% (67/217) and 60.4% (131/217) patients have survived to hospital discharge. Mortality was significantly associated with older age, lower body mass index, chronic renal disease, higher Sequential Organ Failure Assessment score, lower PaO2/FIO2 ratio, higher D-dimer, higher C-reactive protein, and receipt of mechanical ventilation, vasopressors, renal replacement therapy, or vasodilator therapy.

Conclusions: Despite multiple reports of mortality rates exceeding 50% among critically ill adults with coronavirus disease 2019, particularly among those requiring mechanical ventilation, our early experience indicates that many patients survive their critical illness.