Clinical characteristics and outcomes of critically ill patients with novel coronavirus infectious disease (COVID-19) in China: a retrospective multicenter study

Intensive Care Med. 2020 Oct;46(10):1863-1872. doi: 10.1007/s00134-020-06211-2. Epub 2020 Aug 20.


Purpose: An ongoing outbreak of coronavirus disease 2019 (COVID-19) emerged in Wuhan since December 2019 and spread globally. However, information about critically ill patients with COVID-19 is still limited. We aimed to describe the clinical characteristics and outcomes of critically ill patients with COVID-19 and figure out the risk factors of mortality.

Methods: We extracted data retrospectively regarding 733 critically ill adult patients with laboratory-confirmed COVID-19 from 19 hospitals in China through January 1 to February 29, 2020. Demographic data, symptoms, laboratory values, comorbidities, treatments, and clinical outcomes were collected. The primary outcome was 28-day mortality. Data were compared between survivors and non-survivors.

Results: Of the 733 patients included in the study, the median (IQR) age was 65 (56-73) years and 256 (34.9%) were female. Among these patients, the median (IQR) APACHE II score was 10 (7 to 14) and 28-day mortality was 53.8%. Respiratory failure was the most common organ failure (597 [81.5%]), followed by shock (20%), thrombocytopenia (18.8%), central nervous system (8.6%) and renal dysfunction (8%). Multivariate Cox regression analysis showed that older age, malignancies, high APACHE II score, high D-dimer level, low PaO2/FiO2 level, high creatinine level, high hscTnI level and low albumin level were independent risk factors of 28-day mortality in critically ill patients with COVID-19.

Conclusion: In this case series of critically ill patients with COVID-19 who were admitted into the ICU, more than half patients died at day 28. The higher percentage of organ failure in these patients indicated a significant demand for critical care resources.

Keywords: COVID-19; Critically ill; Mortality; Organ failure.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Betacoronavirus
  • COVID-19
  • China / epidemiology
  • Coronavirus Infections / complications*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / virology
  • Critical Illness*
  • Disease Outbreaks
  • Female
  • Humans
  • Intensive Care Units*
  • Kidney Diseases / epidemiology
  • Kidney Diseases / etiology
  • Male
  • Middle Aged
  • Nervous System Diseases / epidemiology
  • Nervous System Diseases / etiology
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / virology
  • Proportional Hazards Models
  • Respiratory Insufficiency / epidemiology
  • Respiratory Insufficiency / etiology
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Shock / epidemiology
  • Shock / etiology
  • Thrombocytopenia / epidemiology
  • Thrombocytopenia / etiology