Critical Care Transport of Patients With COVID-19

J Intensive Care Med. 2021 Jun;36(6):704-710. doi: 10.1177/08850666211001797. Epub 2021 Mar 22.

Abstract

Purpose: Critical care transport is associated with a high rate of adverse events, and the risks and outcomes of transporting critically ill patients during the COVID-19 pandemic have not been previously described.

Materials and methods: We performed a retrospective review of transports of subjects with suspected or confirmed COVID-19 from sending hospitals to tertiary care hospitals in Boston. Follow-up data were obtained for patients transported between March 1st and April 20th, 2020.

Results: Of 254 charts identified, 250 patients were transported. Nine patients (3.5%) had cardiac arrest prior to transport. Twenty-nine (11.6%) had hypotension, 22 (8.8%) had a critical desaturation, and 4 (1.6%) had both en route. Hospital follow-up data were available for 189 patients. Of those intubated during their hospitalization, 44 (25.0%) had died, 59 (33.5%) had been extubated, and 13 (17.6%) had been discharged alive. For the subgroup with prior cardiac arrest, follow-up data available for 6. Of these 6, 2 died and 4 (66.7%) have been discharged alive.

Conclusions: Few patients with COVID-19 had an adverse event in transport. The in-hospital mortality rate was 25%, with a 33.5% extubation rate. Patients resuscitated from cardiac arrest prior to transport had a 66.7% discharge rate among those transported to consortium hospitals.

Keywords: COVID-19; acute respiratory distress syndrome; critical care transport; mortality.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / complications
  • COVID-19 / mortality*
  • COVID-19 / therapy*
  • Critical Care*
  • Female
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Patient Transfer
  • Respiration, Artificial
  • Retrospective Studies
  • Transportation of Patients*
  • Young Adult