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Medicine (Baltimore) ; 100(9): e24604, 2021 Mar 05.
Article in English | MEDLINE | ID: covidwho-1114903


ABSTRACT: Mortality of critically ill patients with coronavirus disease 2019 (COVID-19) was high. Aims to examine whether time from symptoms onset to intensive care unit (ICU) admission affects incidence of extra-pulmonary complications and prognosis in order to provide a new insight for reducing the mortality. A single-centered, retrospective, observational study investigated 45 critically ill patients with COVID-19 hospitalized in ICU of The Third People's Hospital of Yichang from January 17 to March 29, 2020. Patients were divided into 2 groups according to time from symptoms onset to ICU admission (>7 and ≤7 days) and into 2 groups according to prognosis (survivors and non-survivors). Epidemiological, clinical, laboratory, radiological characteristics and treatment data were studied. Compared with patients who admitted to the ICU since symptoms onset ≤7 days (55.6%), patients who admitted to the ICU since symptoms onset >7 days (44.4%) were more likely to have extra-pulmonary complications (19 [95.0%] vs 16 [64.0%], P = .034), including acute kidney injury, cardiac injury, acute heart failure, liver dysfunction, gastrointestinal hemorrhage, hyperamylasemia, and hypernatremia. The incidence rates of acute respiratory distress syndrome, pneumothorax, and hospital-acquired pneumonia had no difference between the 2 groups. Except activated partial thromboplastin and Na+ concentration, the laboratory findings were worse in group of time from symptoms onset to ICU admission >7 days. There was no difference in mortality between the 2 groups. Of the 45 cases in the ICU, 19 (42.2%) were non-survivors, and 16 (35.6%) were with hospital-acquired pneumonia. Among these non-survivors, hospital-acquired pneumonia was up to 12 (63.2%) besides higher incidence of extra-pulmonary complications. However, hospital-acquired pneumonia occurred in only 4 (15.4%) survivors. Critically ill patients with COVID-19 who admitted to ICU at once might get benefit from intensive care via lower rate of extra-pulmonary complications.

COVID-19 , Critical Care , Critical Illness , Symptom Assessment , Time-to-Treatment/statistics & numerical data , Acute Kidney Injury/diagnosis , Acute Kidney Injury/etiology , COVID-19/complications , COVID-19/diagnosis , COVID-19/mortality , COVID-19/physiopathology , China/epidemiology , Critical Care/methods , Critical Care/statistics & numerical data , Critical Illness/mortality , Critical Illness/therapy , Digestive System Diseases/diagnosis , Digestive System Diseases/etiology , Female , Healthcare-Associated Pneumonia/diagnosis , Healthcare-Associated Pneumonia/mortality , Heart Diseases/diagnosis , Humans , Hyperamylasemia/diagnosis , Hyperamylasemia/etiology , Hypernatremia/diagnosis , Hypernatremia/etiology , Male , Middle Aged , Outcome and Process Assessment, Health Care , Prognosis , SARS-CoV-2/isolation & purification , Survival Analysis , Symptom Assessment/methods , Symptom Assessment/statistics & numerical data