Zachary Creech
Creighton University School of Medicine, Medical Student
Creighton University School of Medicine
Omaha, NE
Disclosure information not submitted.
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Renuga Vivekanandan, M.D.
Physician
Creighton University School of Medicine, United States
Disclosure information not submitted.
Chris Destache, PharmD
Doctor of Pharmacy
CHI Health Pharmacy Division, United States
Disclosure information not submitted.
Maureen Tierney, M.D.
Chair, Department of Clinical Research
Creighton University School of Medicine, United States
Disclosure information not submitted.
Manasa Velagapudi, M.D.
Physician
CHI Health - Creighton University Medical Center - Bergan Mercy, United States
Disclosure information not submitted.
Title: Discharge Disposition of COVID-19 Patients Admitted to the Intensive Care Unit (ICU)
Introduction: The COVID-19 pandemic has brought attention to the long and short-term sequelae of the SARS-CoV-2 virus. This study aimed to examine the discharge disposition, length of hospitalization, ICU admission, and mortality of COVID-19 patients admitted to Catholic Health Initiative (CHI) Health Nebraska.
Methods: Data from all patients from March 1 through July 15, 2020, with a positive SARS-CoV-2, polymerase-chain-reaction (PCR) test, were collected regarding their health on admission, their progress during hospitalization, and their disposition after dismissal. Data were analyzed using SPSS-PC (ver 27.0). Emphasis was placed on critical care admission and skilled nursing facility (SNF) placement for patients. Continuous variables were analyzed using Student t-test, and discrete variables were analyzed using Chi-square or Fisher’s exact test. Apriori significance was p ≤ 0.05.
Results: A total of 375 COVID-19 positive patients (176 males; 199 females) were admitted to CHI Health Nebraska facilities throughout Nebraska and western Iowa from March 1 through July 15, 2020. Significantly more male patients (58%; p< 0.01) were admitted to an ICU. Bodyweight (93.9 ± 32.6 vs. 83.1 ± 23.5 kg) and Acute Physiologic Assessment and Chronic Health Evaluation (APACHE II) score (12.6 ± 7.6 vs. 8.9 ± 5.6, P< 0.01) on admission to ICU were significantly (p < 0.01) higher compared to patients admitted to the general floor with COVID-19. Overall mortality was 17% of all 375 hospitalized COVID-19 population. 112 (32%) COVID-19 patients were admitted to the ICU, and all required intubation. Significant numbers of intubated ICU patients, 20 (23%) required SNF (p=0.032) placement. 69 out of 242 (28.5%) non-ICU patients required SNF placement. The total length of hospitalization was significantly longer for patients discharged to a SNF (21.5 ± 13.9 compared to 10.8 ± 9.9 days, p< 0.001).
Conclusion: The health implications after COVID-19 hospitalization are still being investigated. Patients admitted to the ICU with COVID-19 early during the pandemic had significantly higher APACHE II scores and body weight compared to non-ICU patients. A significant number of ICU patients and non-ICU patients (over 25%) required SNF placement. Furthermore, patients discharged to a SNF required longer hospitalization.