ABSTRACT
Background: Given the devastating impact that COVID-19 can have on the lung, it is reasonable to fear for patients with underlying chronic lung conditions. Recent studies have shown that there is an excess risk of contracting the infection, as well as developing severe symptoms and worst outcomes for some of these conditions. We present a single center experience of the characteristics and outcomes of patients admitted due to with confirmed SARS-CoV-2 infection and chronic lung disease. Methods: Retrospective medical records review of patients with chronic lung conditions (COPD, asthma, interstitial lung disease, pulmonary hypertension, and lung cancer) and SARS-CoV-2 infection between January 1, 2020 and December 1, 2020 at Beth Israel Deaconess Medical Center, Boston, MA. Patients were identified from our institutional database. Demographics, baseline comorbidities, hospital say, ICU admission, and interventions performed were recorded. Results: 12.405 patients were diagnosed with SARS CoV-2 infection at BIDMC. From the total, 961 (7.8%) patients were admitted for further care with an age of 66 years (IQR 52-78), 464 (48.28%) males, and a BMI of 29.8 kg/m2 (IQR 25.8-34.6). Regarding the comorbid conditions, 157 subjects (16.3%) had COPD, 157 (16.3%) asthma, 24 (2.50%) pulmonary hypertension, 14 (1.46%) ILD and 18 (1.87%) lung cancer. We found that patients with COPD (23.57% vs 14.68%, p=0.005) as well as lung cancer (38.89% vs 15.69%, p=0.016) died more often after hospital admission. Additionally, a logistic regression model for mortality showed an OR of 1.8 (95%CI 1.2-2.7, p=0.006) for COPD and an OR of 3.42 (95%CI 1.30-8.96, p=90.012) for lung cancer. Conclusion: Our review showed that patients hospitalized due to SARS CoV-2 infection, and a previous diagnosis of COPD or lung cancer, were more likely to die during the hospital stay. (Table Presented).
ABSTRACT
Background: Acute Distress Respiratory Syndrome (ARDS) develops in 42% of patients presenting with COVID19 pneumonia, and 61-81% of those requiring intensive care. Tracheostomy placement is still a subject of controversy due to the poor prognosis of intubated patients and the risk of transmission to health care providers through this highly aerosolizing procedure. In this study we aim to determine the outcomes of tracheostomized patients with ARDS due to COVID-19 and ARDS to non-COVID-19. Methods: We performed a single center retrospective review of patients diagnosed with SARS-CoV-2 and who underwent tracheostomy due to ARDS between January 2020 and November 2020. Patients were identified from our institutional database. Demographics, baseline comorbidities, mortality, intensive care unit (ICU) stay, duration of ventilator requirement, tracheostomy procedure details, complications, and length of stay. Results: The average time from endotracheal intubation to tracheostomy was 25.56 ± 7.58 days and 25.56 ± 6.35 days for SARS-CoV-2 positive and SARS-CoV-2 negative, respectively. In the SARS-CoV-2 positive group, eleven patients (32.4%) were liberated from the ventilator, six (17.6%) were decannulated, and nine (26.5%) remained on MV. In contrast, in the SARS-CoV-2 negative group five patients (27.8%) were liberated from the ventilator, eight (44.4%) were decannulated, and three (16.7%) remained on MV. The median time from tracheostomy to ventilator liberation was 19 days (range 10-41 days) and 32 days (range 24-49 days) for SARS-CoV-2 positive and SARS-CoV-2 negative, respectively. Of patients who were successfully decannulated, the average time to decannulation was 34.17 ± 16.88 days and 42.00 ± 13.01 days for SARS-CoV-2 positive and SARS-CoV-2 negative, respectively. There was no significant difference in mortality between both groups. Conclusions: In patients with ARDS, there are no statistical differences between SARS-CoV-2 positive and SARS-CoV-2 negative patients in terms of mortality, ventilator liberation, and decannulation time.