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Background: The aim of this study was to describe the prevalence of persistent symptoms of COVID in hospitalized pediatric population one year after admission compared to a control group. Method(s): Prospective observational study conducted in 2 hospitals. We included patients aged 0-18 years hospitalized for acute COVID-19 more than a year ago and controls, matched by age and sex, hospitalized for causes other than COVID-19, and who had never COVID-19 at recruitment or during the follow-up. Families were contacted and a standardized survey was conducted. Persistent COVID/disease was defined as the presence of symptoms with onset in the first 3 months after COVID-19 and with persistence for more than 2 months. Result(s): 50 cases and 46 controls were analyzed, 58.3% male, 36% <5 years. Families were interviewed a median of 1.89 years (interquartile range;1.25-2.07) after hospitalization. The definition of persistent COVID-19/disease was met in 34% of cases vs. 37% of controls (p=0.767). Symptoms persisted >=11 months in 24% (12/50) of cases vs. 13% (6/46) of controls (p=0.182), with no differences by age group. The most frequent symptoms at 1 year in cases were fatigue (8%), headache (6%), poor appetite (6%), abdominal pain (6%) and variations in heart rate (6%). In controls, persistent symptoms were mostly abdominal pain (6%) and poor appetite (6%). The number of readmissions was 11/50 (22%) and 6/46 (13%) (p=0.267), respectively. On emotional/behavioral items, 16/50 (32%) of cases reported that their emotional state was worse or much worse than before admission, compared to 16/46 (34.7%). No risk factors associated with the development of persistent symptoms were found, except the length of hospital admission (p=0.043). Conclusion(s): In this study, the prevalence of persistent symptoms was not different in patients with and without COVID-19. 1-year persistence was higher in COVID-19 cases but did not reach significance. Persistence correlated with length of hospitalization.
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Background: Long term evolution of Multisystem Inflammatory Syndrome in children (MIS-C) is poorly understood. In this report, we described the frequency of persistent symptoms and sequels after one-year monitoring in a cohort of MIS-C patients. Method(s): This is a prospective observational study in under-18-aged patients diagnosed with MIS-C between October 2020 and April 2021 in a tertiary hospital. Data from initial episode was obtained from the Spanish national database and the medical history. A standardized phone questionnaire was done one year after the acute episode. As patients pared by age and sex were included with i) history of acute COVID-19, from the same national database, and ii) with peritonitis diagnosis in the electronic medical record. Data was collected using REDCap and analysed with R. Ethics committee approval was obtained. Result(s): A total of 48 patients were included in the study, 16 in each group. Average age at hospitalization was 11,2 years old [IQR: 6,6-14,4] and 52% (23/48) were male. MIS-C patients presented high frequently 94% (15/16) cardiological complications during hospitalization, in contrast with 19% (3/16) of acute COVID-19 patients and 25% (4/16) of peritonitis group (p< 0.01). All of them resolved after a year except the ones associated to hypoxic ischemic encephalopathy in a patient with MIS-C that need ECMO assistance. Summary characteristics during acute episode are shown in Table 1. After one-year follow-up, 88% MIS-C patients suffered one or more symptoms, more frequently: headache (44%), fatigue (38%), insomnia (38%) and concentration problems (38%). A total of 56% of COVID-19 patients presented persisted symptoms, mainly fatigue and concentration problems (19%), and 31% in peritonitis group (19% loss of appetite and abdominal pain), (p< 0.001). MIS-C patients visited more frequently the medical professionals due to emotional change, behaviour or interpersonal relationships after the disease [4/16 (25%) in MIS-C vs. 0/16 (0%) in both control groups, p= 0.028]. Conclusion(s): Majority of MIS-C patients have persistent symptoms one year after acute episode, even with the resolution of cardiological complications. Frequency of long term symptoms in MIS-C patients is significantly higher than in COVID-19 hospitalized and than in a control group of surgical peritonitis patients. Summary characteristics during acute episode.
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Lack of thermal comfort in the existing building stock in many warm summer climates and the COVID-19 pandemic have increased residents' temporary occupation of urban open spaces. However, climate change and other effects such as urban heat islands are also negatively affecting the livability of these spaces. Therefore, strategies are needed to improve the thermal conditions in these areas. In this context, the research designs, simulates and assesses an urban green infrastructure supported by an adaptative solar shading system. For this purpose, a public square to be renovated in Seville (Spain) is chosen. After an analysis of the current situation, more vegetation is added. However, trees are not planted fully grown, so their cover is not enough in the short term and an artificial system that protects from the sun by casting shade and that adapts to both their growth and the seasons is included. The urban space is characterized by on-site measurements, proposing four (initial, intermediates and final) scenarios using computational fluid dynamics simulations in an holistic microclimate modelling system. In turn, changes in thermal comfort are analyzed using the COMFA model. Results show that the air and surface temperature are decreased, reducing the number of hours in discomfort by 21% thanks to incorporating the green structure and by 30% due to the vegetation. It can be concluded that the use of these temporary urban prostheses enables urban spaces regenerated with vegetation to be enjoyed without waiting 20 or 30 years for the trees to mature, encouraging people to spend more time outdoors from the start of the intervention. © 2023 The Authors
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Background and importance The Pharmacy Service is committed to resident training. The residency programme in the Hospital Pharmacy Service covers all areas of the training programme. The high hospital demand and the weekly updates of the pharmaceutical protocols made it necessary to dedicate almost the entire working day to the hospital pharmacy residents. Aim and objectives To evaluate the impact of the SARS-CoV pandemic on the training period of resident pharmacist interns. Material and methods A survey was conducted among all hospital pharmacy residents in Spain. It was carried out by the Teaching and Hospital Pharmacy units. The survey was anonymous, voluntary and disinterested. Data collected: place of residence, year of training, hospital level, resident supervision, internal and external rotations missed, emotional impact and sick leave. Results The survey was completed by 122 hospital pharmacy residents. The completion period was from 15 March to 15 April 2021. The geographic distribution of the residents was: Andalusia (48.3%), Madrid (11.7%), Catalonia (10%), Valencia (8.3%), Murcia (8.3%), Castilla y León (3%), Galicia (3%), Asturias (1.7%), Cantabria (1.7%) and the Basque Country (1.7%). The year of residence of the respondents was: 4th year (56.7%), 2nd year (18.3%), 1st year (13.3%) and 3rd year (11.7%). With respect to supervision and concern for the work: 65.6% felt adequately supervised, while 27.9% said they were deficient in the process. Regarding rotations in other services and/or hospitals: 50.8% stated that they had missed some type of rotation, of which 13.1% were irrecoverable. 63.9% recognized that the pandemic has had some emotional impact on their lives, while 34.4% stated that it has had a great impact. Of the residents, 50.81% said they had been on sick leave due to SARS-CoV. Conclusion and relevance Pharmacy services met the demand of the hospital and associated residences with increased activity. Despite the situation, residency in a crucial stage of professional training, therefore changes must be faced in order to find the best way to meet the goals.
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Background. Reports in adults with COVID-19 and acute otitis media (AOM) show that severe symptoms and hearing loss may be more common than with the clinical presentation of typical AOM. However, the association of SARS-CoV-2 with AOM in children is poorly understood. Methods. Cases were identified as a subpopulation enrolled in the NOTEARS prospective AOM study in Denver, CO from March-December 2020. Children enrolled were 6-35 months of age with uncomplicated AOM and prescribed amoxicillin. Children diagnosed with AOM and SARS-CoV-2, detected by polymerase chain reaction assay, were included in the case series. Data was obtained from electronic medical records and research case report forms. Patients completed surveys at enrollment and 5, 14 and 30 days after enrollment that included the Acute Otitis Media Severity of Symptoms (AOM-SOS©) scale. All patients had nasopharyngeal otopathogen testing completed. Results. A total of 108 patients had been enrolled through December 2020 (all of whom were subsequently tested for SARS CoV-2). During the study period for this case series, 16 patients were enrolled, and 7 (43.6%) were identified with AOM/SARS-CoV-2 co-infection. Among these 7 patients, fever was present in 3 children (29%). Four children (57%) attended daycare. Only 2 children (29%) had testing for SARS CoV-2 as part of their clinical workup. Mean AOM-SOS © scores were similar among the SARS CoV-2 positive and negative patients with no statistical significance noted with two-sided t-tests: 13.6 (± 4.5) vs 14.2 (± 4.9) at enrollment, 1.4 (± 1.8) vs 4.2 (±4.9) on Day 5, and 0.6 (± 0.9) vs. 2.5 (±6.1) on Day 14 (Table 1). Among the 7 patients, no child had an AOM treatment failure or recurrence. Of the 6 patients in whom bacterial and viral testing have been completed, a bacterial otopathogen was identified in 6 (100%), and a viral pathogen in 3 (50%) children (Table 2). Conclusion. SARS-CoV-2 can occur in children with AOM. It is important that providers maintain a high index of suspicion for COVID-19 even in patients with clinical evidence of AOM, particularly to ensure families are appropriately advised on isolation and quarantine requirements. AOM with SARS-CoV-2 does not appear to be more severe than AOM without SARS-CoV-2.
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Background. The temporal dynamics of SARS-CoV-2 infectivity in immunocompromised children (IC) are unknown but may have important infection control implications. We evaluated SARS-CoV-2 viral persistence and assessed factors associated with viral persistence and cycle threshold (CT) values as a surrogate of viral load for IC. Methods. We conducted a retrospective cohort study of SARS-CoV-2-positive IC at a large quaternary pediatric hospital from March 2020-2021. Immunocompromised status was defined as primary or secondary/acquired immunodeficiencies due to comorbidities or immunosuppressive treatment. The primary outcome was time to first-of-two consecutively negative SARS-CoV-2 PCR tests ≥ 24 hours apart. Polymerase chain reaction (PCR) testing of sequential patient samples was conducted using the Centers for Disease Control 2019-nCoV Real-Time RT-PCR Diagnostic Panel (CDC assay). Chi-square, Fisher exact, and Wilcoxon tests were used to compare demographic and clinical characteristics. Kaplan-Meier curve median event times and log-rank tests were used to compare outcomes. Subjects without 2 consecutive negative tests censored at the last test. Analyses were conducted using SAS v 9.4. Results. Ninety-one children met inclusion criteria, and 67 children had more than 1 test (Figure 1). Median age was 15.5 years (IQR 8-18 yrs), 64% were male, 58% of children were white, and 43% were Latinx. Most (67%) were tested in outpatient settings, and 58% of children were asymptomatic. The median time to two negative tests was 42 days (IQR 25.0,55.0), with no difference in duration of positivity with specific diagnoses, degree of lymphopenia, or symptomatic vs asymptomatic illness. Five of 7 (71%) children with samples available for repeat testing had initial CT values < 30, indicating a moderate to high viral load, and of these, 4 (57%) had repeat testing 21 to 30 days later with CT values < 30 (Figure 2), suggesting persistence of moderate to high viral loads. Figure 1. Plot of immunocompromised children in cohort with positive SARS CoV2 PCR and subsequent testing (n = 67). Timelines of immunocompromised children in cohort with positive SARS CoV2 PCR and subsequent testing, grouped by immunocompromising condition. Each line represents an individual patient. Positive results are shown in light grey, negative results are shown in black. Figure 2. Plot of CT values from SARS-CoV-2 PCR testing over time among children with sequential samples available for retesting (n = 7) Plot of CT values (y axis) from SARS-CoV-2 PCR testing on the CDC assay over time (x axis) in days from initial positive test. Repeated testing which yielded a negative result on the CDC assay or intermittent negative results on clinical testing represented as CT value of 40. Each line represents a unique patient. Conclusion. The median duration of viral persistence among IC with SARS-CoV-2 infection was 6 weeks, with no significant difference in immunocompromised diagnoses or clinical presentation, with over half of children with testing on the same platform having moderate to high viral loads after 3 weeks, suggesting potential transmission risk.
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Background The 2012 Neonatal Early Onset Infection Guideline by National Institute for Clinical Excellent (NICE) [CG149], led to an increase in antibiotic use in well newborns. The Kaiser Permanente Sepsis Risk Calculator (KP-SRC) uses the population's background incidence of EOS, objective information at birth and the infant's clinical presentation to evaluate risk of neonatal EOS in infants >34 weeks gestation. This has safely shown to reduce the use of antibiotics. During the COVID-19 pandemic, the local Operational Delivery Network endorsed the use of the KP-SRC. Objectives To show implementation of KP-SRC can safely and effectively reduce the incidence of antibiotic use in well babies over 34 weeks gestation without an increase in missed cases of sepsis. Methods KP-SRC was implemented in 4 neonatal units. KPSRC is used on all babies with risk factors for infection in accordance with the NICE EOS guideline [CG149] and antibiotics are started according to the recommended outcome. There was slight variation in the parameters used by the units in the calculation of KP-SRC (i.e. Infection incidence rate of 0.8/1000 in 2 units and 0.6/1000 in the other 2 units). Blood culture data during the first seven days of life was provided on a monthly basis by the laboratories. Babies < 34 weeks gestation were excluded and clinical details of the remaining babies were reviewed, particularly with respect to positive blood cultures and readmissions following discharge home. Data was reviewed over a consecutive 5 month period prior to implementation of the KP-SRC (1 Sept 2019 - 31 Jan 2020), and post implementation (1 Sept 2020 - 31 Jan 2021). Results There was a percentage reduction in blood cultures taken in the post KP-SRC implementation period between the 4 units of 52 to 85% (mean 60%). There were 5 positive blood cultures, all babies were commenced on antibiotics at birth in accordance with the KP-SRC recommendation. Twenty babies were started on antibiotics after 24 hours of age and received 5 days of antibiotics. Twelve had no risk factors for infection and would not have been picked up by NICE. Of the eight assessed by KP-SRC, two were admitted to the neonatal unit on day 2 with tachypnea but did not require respiratory support. Only one baby was readmitted following discharge and received 5 days of antibiotics. This baby was readmitted on day 7 with apnoea requiring ventilation. There was a history of maternal prolonged rupture of membranes and mild maternal pyrexia but the baby was well in the immediate postnatal period. Blood cultures were negative with normal CRP's. Conclusions The KP-SRC can lead to a safe and consistent reduction in the number of well babies receiving antibiotics post-delivery. All babies with positive blood cultures were on antibiotics as guided by the KP-SRC and there were no missed cases of sepsis.
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The COVID-19 pandemic has spurred the development and application of new technologies in telemedicine to overcome limitations on in-person interactions between patients and doctors. In particular, increased use of computer simulations can help us identify underlying mechanisms for pathologies and which treatments may be best suited for them when in-person appointments are not feasible. For example, long QT syndrome (LQTS) is a cardiac condition that can lead to potentially fatal arrhythmias. One of the most common long QT syndromes, LQT1, causes structural abnormalities of potassium ion channels that in turn reduce certain potassium currents at the cellular level in the heart. In this paper, we use the extracellular-membrane-intracellular (EMI) model to simulate the effects of LQTS. The EMI model resolves the detailed characteristics of individual cell membranes, which is where the affected ion channels are localized, thus making it uniquely suitable for studying such effects. We compare simulations from data from healthy cells, cells that exhibit LQT1 syndrome, and cells that have been treated with a drug to restore healthy heart function. These simulations demonstrate that advances in biomedical engineering combined with computer simulation can enhance the power and applicability of telemedicine well beyond the current state. © 2021, Springer Nature Switzerland AG.
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Background: Universal pre-operative screening with SARS-CoV-2 PCR has been adopted by institutions to mitigate risk to healthcare workers (HCW) during aerosol- generating procedures such as intubation. However, there remains uncertainty regarding rates of false negative results and optimal sampling type. The objective was to determine the reliability of single, pre-operative SARS-CoV-2 testing from the nasopharynx in children undergoing general anesthesia. Methods: Children < 18 years of age who underwent intubation for a procedure received pre-operative testing 24-48 hours prior with a nasopharyngeal (NP) swab or wash, in conjunction with intra-operative nasal wash (NW) and tracheal aspirate (TA) sampling. All paired samples underwent testing using the Simplexa DiaSorin platform or a modified Centers for Disease Control assay. Cohen's Kappa was used for interrater reliability of each sample result. McNemar's Test was used to compare result proportions by sample type. Positive and negative predictive values (PPV, NPV) were calculated based on the intraoperative NW as the reference standard. Analyses were conducted using SAS (v 9.4). Results: We collected full sample sets from 364 children from April 14 to May 15;66% of pre-operative samples were NP swabs. The median age was 6 years (IQR 2,13), 55% were male, 68% were white and 41% of children had a high-risk comorbidity. Most surgeries were conducted by general surgery (23%), followed by orthopedics (19%). Only 2.5% of children had respiratory symptoms, and 4.8% had a documented fever within a week of the procedure. SARS-CoV-2 positive samples occurred in 4/364 (1%) of pre-operative samples, 8/363 (2.2%) of intra-operative samples, and 8/348 (2.3%) of TA samples. The pre-operative test had 100% PPV and 99% NPV, and the TA had 100% PPV and 98.6% NPV (Table 1). There was very good agreement (Figure) between pre- and intraoperative upper respiratory sampling, with a Kappa of 0.66, (95% CI 0.35-0.97). There was no statistical difference in results by sample type. (Table Presented). Conclusion: There is a high PPV and NPV of pre-operative SARS-CoV-2 PCR testing among children undergoing anesthesia. These data can help inform guidelines regarding appropriate precautions for HCW performing high risk procedures in asymptomatic pediatric patients. (Table Presented).
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Introduction: Pulmonary exacerbations (PEx) in cystic fibrosis (CF) may be caused by viruses, bacterial infections, environmental or host triggers. For children admitted for a PEx, the admitting provider often decides whether to test for viral infections based upon clinical assessment. Given the similarity of symptoms between bacterial and viral causes, providers may miss patients who are viral positive and thus, institute inadequate infection control measures. To address this epidemiologic concern, we performed a quality improvement project to determine the frequency of viral infections in children with CF admitted for PEx and to assess the reliability of provider assessment to predict viral infections. Methods: From December 2019 to May 2020, all patients with CF admitted for PEx had a PCR-based respiratory pathogen panel (RPP) performed at the time of admission. In March 2020, SARS-CoV-2 testing was added. A questionnaire was filled out by the admitting clinician prior to the resulted RPP. Clinicians provided yes/no responses regarding viral symptoms and stated whether they suspected a viral infection. If a patient had confirmed viral studies prior to admission, the questionnaire was not completed. Results: From December to May, there were 28 admissions for CF pulmonary exacerbations. Of these, 15 patients with CF admitted for 16 pulmonary exacerbations had provider questionnaires completed. The RPP was positive in 4 (25%) of patients (two non-SARS-CoV-2 coronavirus strains, one rhino/enterovirus, one Mycoplasma). Clinicians correctly identified the etiology of the exacerbation in 11 (68.8%) cases, missing only one viral-positive infection. The question “do you think this patient has a virus?” showed a sensitivity of 42.8% (9.9% to 81.6%) and a specificity of 88.9% (51.6% to 99.7%) based on RPP results. Discussion: Clinicians at our institution were able to correctly identify almost 70% of presenting PEx based upon RPP results, with one RPP-positive infection being missed. Sensitivity was low, suggesting that children may be placed in unnecessarily strict isolation precautions or conversely, have unsuspected viral infections at the time of PEx that may result in inadequate precautions and thus risking spread to other patients and hospital staff based on clinical assessment alone. The number of children admitted with PEx was unexpectedly small likely due to the initiation of elexacaftor/ tezacaftor/ivacaftor in many of our patients. Also, given COVID-19 screening implementations, many patients had RPP results available prior to clinician assessment.
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In the province of Santiago de Cuba, Cuba, the COVID-19 epidemic has a limited progression that shows an early small-number peak of infections. Most published mathematical models fit data with high numbers of confirmed cases. In contrast, small numbers of cases make it difficult to predict the course of the epidemic. We present two known models adapted to capture the noisy dynamics of COVID-19 in the Santiago de Cuba province. Parameters of both models were estimated using the approximate-Bayesian-computation framework with dedicated error laws. One parameter of each model was updated on key dates of travel restrictions. Both models approximately predicted the infection peak and the end of the COVID-19 epidemic in Santiago de Cuba. The first model predicted 57 reported cases and 16 unreported cases. Additionally, it estimated six initially exposed persons. The second model forecasted 51 confirmed cases at the end of the epidemic. In conclusion, an opportune epidemiological investigation, along with the low number of initially exposed individuals, might partly explain the favorable evolution of the COVID-19 epidemic in Santiago de Cuba. With the available data, the simplest model predicted the epidemic evolution with greater precision, and the more complex model helped to explain the epidemic phenomenology.
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Background and objectives There is limited information on outcome, complications and treatments of critically ill COVID-19 patients requiring admission to an intensive care unit (ICU). The aim of this study is to describe the clinical ICU course, treatments used, complications and outcomes, of critically ill COVID-19 patients admitted in seven ICU in Galicia region during the 2020 March–April pandemic peak. Methods Between March 21 and April 19, 2020, we evaluated critically ill COVID-19 patients admitted to the ICU of Anesthesia of seven hospitals in Galicia, northwestern Spain. Outcome, complications, and treatments were monitored until May 6, 2020, the final date of follow-up. Results A total of 97 critically ill COVID-19 patients were included. During ICU stay, mechanical ventilation became necessary in 80 (82.5%) patients, and tracheostomy in 22 (22.7%) patients. Prone position was used frequently in both intubated (67.5%) and awake (27.8%) patients. Medications consisted of antivirals agents (92.7%), corticosteroids (93.8%), tocilizumab (57.7%), and intermediate or high doses of anticoagulants (83.5%). The most frequent complications were ICU-acquired infection (52.6%), thrombosis events (16.5%), and reintubation (9.3%). After a median follow-up of 42 (34–45) days, 15 patients (15.5%) deceased, 73 patients (75.2%) had been discharged from ICU, and nine patients (9.3%) were still in the ICU. Conclusions A high proportion of our critically ill COVID-19 patients required mechanical ventilation, prone positioning, antiviral medication, corticosteroids, and anticoagulants. ICU complications were frequent, mainly infections and thrombotic events. We had a relatively low mortality of 15,5%. Resumen Antecedentes y objetivos Existe poca información sobre la evolución, complicaciones y los tratamientos recibidos por los pacientes críticos con COVID-19 que requieren ingreso en una unidad de cuidados intensivos (UCI). El objetivo de este estudio es describir la evolución clínica, los tratamientos utilizados, las complicaciones y resultados de pacientes críticos COVID-19 ingresados en siete UCI de Anestesiología en la Región de Galicia durante el pico de la pandemia en marzo-abril 2020. Métodos Entre el 21 de marzo y el 19 de abril de 2020 evaluamos todos los pacientes críticos COVID-19 ingresados en las UCI de Anestesiología de siete hospitales en Galicia, en el Noroeste de España. Los resultados, complicaciones y los tratamientos administrados se registraron hasta el 6 de Mayo de 2020, fecha final del seguimiento. Resultados Un total de 97 pacientes críticos COVID-19 fueron incluidos. Durante su estancia en UCI, 80 pacientes (82,5%) necesitaron ventilación mecánica, y 22 pacientes (22,7%) traqueotomía. El decúbito prono se usó frecuentemente en pacientes intubados (67,5%) y despiertos (27,8%). Las medicaciones usadas fueron antivirales (92,7%), corticoides (93,8%), tocilizumab (57,7%), y dosis intermedias y altas de anticoagulantes (83,5%). Las complicaciones más frecuentes fueron infecciones adquiridas en UCI (52,6%), eventos trombóticos (16,5%), y reintubationes (9,3%). Tras un seguimiento medio de 42 (34–45) días, 15 pacientes fallecieron (15,5%), 73 pacientes (75,2%) habían sido dados de alta de UCI y nueve pacientes (9,3%) permanecían todavía en la unidad. Conclusiones Un alto porcentaje de nuestros pacientes críticos COVID-19 requirieron ventilación mecánica, posición prona, medicaciones antivirales, corticoides y anticoagulantes. Las complicaciones en UCI fueron frecuentes, principalmente infecciones y eventos trombóticos. Tuvimos una mortalidad relativamente baja del 15,5%.
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BACKGROUND AND OBJECTIVES: There are limited information on outcome, complications and treatments of critically ill COVID-19 patients requiring admission to an intensive care unit (ICU). The aim of this study is to describe the clinical ICU course, treatments used, complications and outcomes, of critically ill COVID-19 patients admitted in seven ICU in Galicia region during the 2020 March-April pandemic peak. METHODS: Between March 21 and April 19, 2020, we evaluated critically ill COVID-19 patients admitted to the ICU of Anesthesia of seven hospitals in Galicia, northwestern Spain. Outcome, complications, and treatments were monitored until May 6, 2020, the final date of follow-up. RESULTS: A total of 97 critically ill COVID-19 patients were included. During ICU stay, mechanical ventilation became necessary in 80 (82.5%) patients, and tracheostomy in 22 (22.7%) patients. Prone position was used frequently in both intubated (67.5%) and awake (27.8%) patients. Medications consisted of antivirals agents (92.7%), corticosteroids (93.8%), tocilizumab (57.7%), and intermediate or high doses of anticoagulants (83.5%). The most frequent complications were ICU-acquired infection (52.6%), thrombosis events (16.5%), and reintubation (9.3%). After a median follow-up of 42 (34-45) days, 15 patients (15.5%) deceased, 73 patients (75.2%) had been discharged from ICU, and nine patients (9.3%) were still in the ICU. CONCLUSIONS: A high proportion of our critically ill COVID-19 patients required mechanical ventilation, prone positioning, antiviral medication, corticosteroids, and anticoagulants. ICU complications were frequent, mainly infections and thrombotic events. We had a relatively low mortality of 15,5%.