Nirmala Manjappachar, MD
Internal Medicine Resident Physician
Anne Arundel Medical Center
Annapolis, MD
Disclosure information not submitted.
Adrien Mazer, MD
Intensivist
Anne Arundel Medical Center, United States
Disclosure information not submitted.
Mitchell Karpman, PhD
Biostatistician
Luminis Health Anne Arundel Medical Center, United States
Disclosure information not submitted.
Jennifer Grover, DHSc, MMS, PA-C
Program Lead, Clinical Effectiveness
Anne Arundel Medical Center, United States
Disclosure information not submitted.
Dereddi Raja Reddy, MD, FACP FCCP
Assistant Professor, Program Director MS4 McGovern Medical School
MD Anderson Cancer Care Center
Houston, Texas
Disclosure information not submitted.
Joseph Nates, MBA, MD
Professor, Deputy Chair, Director ICUs
University of Texas MD Anderson Center
Bellaire, Texas, United States
Disclosure information not submitted.
Nargiz Muganlinskaya, MD, MMS, FACP
Program Director, IM
Anne Arundel Medical Center, United States
Disclosure information not submitted.
Title: Comparative Outcomes of Covid-19 Survivors versus Non-survivors in an Academic Intensive Care Unit
Introduction: Despite recent advances in the management of critically ill patients with severe COVID-19, this population still has high-mortality rates. We aimed to study the characteristics and differences between survivors and non-survivors among the patients admitted to our Intensive Care Unit (ICU) with severe infection.
Methods: We included a cohort of survivors and non-survivors admitted with the diagnosis of COVID-19 to our ICU between March 2020 and June 2020. We collected baseline characteristics, respiratory data, interventions, and outcomes. Descriptive statistics are reported.
Results: Among the 121 confirmed COVID-19 positive patients, 55 patients (45.45%) died during their ICU admission. There were significant differences in age (61 vs 70, p= 0.0001) and male sex (68.18% vs 12.72%, p < 0.0001) between survivors and non-survivors. There were no differences in race or body mass index between these two populations of survivors and non-survivors. With regards to ICU resource utilization, significantly less number of survivors required high doses of vasopressors (10.6% vs 83.63%, p < 0.0001) or number of vasopressors (0.123 vs 1.78). There was no difference in ventilator utilization (72.7% vs 83.6, p= 0.15) between the two groups. The number of ventilator days was similar for the two groups (7.5 days vs 9 days, p= 0.6). The survivors required significantly less renal replacement therapy (7.57% vs 27.27%, p= 0.0038). The non-survivors were significantly sicker on admission with median Sequential Organ Failure Assessment (SOFA) score of 10 (6-12) versus 7 (4-11) (p= 0.0348) and remained sicker throughout admission with max SOFA scores of 14 (11-17) versus 11 (6-13) (p= < 0.001). ICU mean length of stay (LOS) was [8 days (5-15) versus 11 days (3-22), p=0.86] and mean hospital LOS was [13 days (7-23) versus 19 (12-36), p= 0.0024] respectively. Among the survivors 31.81% required acute and subacute rehabilitation services post discharge.
Conclusions: In this cohort of critically ill COVID-19 patients, non-survivors had higher severity of illness scores throughout their ICU stay, were male and older, and required more vasopressor and renal replacement therapy support.