PRESENTATION #2 Clinical Research | Critical Care Medicine
CLINICAL CARE OF ADULT PATIENTS WITH A DIAGNOSIS OF COVID-19 (SARS-COV-2): AN INFORMED DECISION ANALYSIS
Vamsidhar Budur, BS, University of Queensland Ochsner Clinical School
Xing Zhou Hou, MS, University of Queensland Ochsner Clinical School
Bobby Nossaman, MD, Ochsner Clinic Foundation Department of Anesthesiology
Presenter: Peter Ayoub, BS
UQ – Ochsner
Purpose: Since the initial reports of the novel coronavirus, COVID-19 (SARS-CoV-2), this outbreak has rapidly spread throughout the world. Although the majority of patients with this infection have mild upper respiratory tract symptoms, patients with comorbidities are prone to developing a pneumonic process, leading to severe acute respiratory syndrome that requires mechanical pulmonary ventilation. The purpose of this retrospective study is to measure the outcomes in this group of patients throughout Ochsner Health. Data derived from this study could lead to protocols to improve patient care.
Methods: 211 patients 18 years or older with a presumptive diagnosis of COVID-19 pneumonia who required orotracheal intubation for respiratory failure were included in the study. All patients were admitted to Ochsner Health between January and May of 2020. Retrospective chart review was performed using Epic to collect patient information such as demographics, admission/discharge times, comorbidities, admission symptoms, admission laboratory results, vital signs, duration of oxygen therapy and mechanical ventilation, ventilation settings, medication treatments, and proning therapy. Statistical analyses were performed using the software JMP, 13.2.
Results: Hospital mortality of admitted patients was 64% (136/211). Proning occurred in 42 patients and was associated with an increased mortality rate (35/42, 83%) compared to patients who did not receive this intervention (101/169, 60%). Heparin therapy resulted in no change in mortality rate (106/164, 65%) compared to those who did not receive heparin (30/47, 64%).
Conclusion: Given the high hospital mortality rate of intubated patients in the Intensive Care Unit diagnosed with COVID-19 infection, strategies must be developed to predict future mortality and guide therapy. These results suggest that further study is warranted regarding the efficacy and safety of existing interventions.