Background: In March 2020, Covid-19 secondary to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was declared a global pandemic.
Methods: This retrospective observational study included patients with Covid-19, managed in a single intensive care unit (ICU). We collected data on patient characteristics, laboratory and radiological findings and ICU management. Data are reported as median (interquartile range). Binary logistic regression modelling was used to identify variables at ICU admission associated with mortality.
Results: 85 patients (age 57.3 years [49.4-64.2], 75.3% male) were followed up for 34 days (26-40). The commonest comorbidities were hypertension (51.8%), obesity (48.7%), and type 2 diabetes (31.8%). Covid-19 presented with shortness of breath (89.4%), fever (82.4%), and cough (81.2%), first noted 8 days (6-10) prior to ICU admission. PaO/FiO-ratios at ICU admission were 8.28 kPa (7.04-11.7). Bilateral infiltrates on chest X-ray, lymphopenia, and raised C-reactive protein and ferritin were typical. 81.2% received invasive mechanical ventilation (IMV). Acute kidney injury occurred in 62.4% with renal replacement therapy required in 20.0%. By the end of the follow-up period, 44.7% had died, 30.6% had been discharged from hospital, 14.1% had been discharged from ICU but remained in hospital and 10.6% remained in ICU. ICU length of stay was 14 days (9-23). Age was the only variable at admission which was associated with mortality. PaO/FiO-ratio, driving pressure and peak ferritin and neutrophil count over the first 72-hours of IMV all correlated with mortality.
Conclusions: We report the clinical characteristics, ICU practices and outcomes of a South London cohort with Covid-19, and have identified factors which correlate with mortality. By sharing our insight, we hope to further understanding of this novel disease.
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http://dx.doi.org/10.1177/1751143720971541 | DOI Listing |
BMC Nurs
January 2025
Departamento de Práticas Assistenciais, Hospital Israelita Albert Einstein, Avenue Albert Einstein, 627-701, São Paulo, 05651-901, Brazil.
Background: Patients hospitalized outside of monitored environments may experience sudden clinical worsening requiring transfer to the Intensive Care Unit. Early detection based on the clinical nurse's identification of the risk of clinical deterioration represents an opportunity to prevent serious adverse events. Nurse worry is defined as the use of clinical reasoning combined with intuition that precedes the patient's clinical deterioration.
View Article and Find Full Text PDFJ Transl Med
January 2025
Department of Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China.
Background: Acute respiratory distress syndrome (ARDS) is a prevalent complication among critically ill patients, constituting around 10% of intensive care unit (ICU) admissions and mortality rates ranging from 35 to 46%. Hence, early recognition and prediction of ARDS are crucial for the timely administration of targeted treatment. However, ARDS is frequently underdiagnosed or delayed, and its heterogeneity diminishes the clinical utility of ARDS biomarkers.
View Article and Find Full Text PDFCrit Care
January 2025
Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, 630 West 168th Street, P&S 3-401, New York, NY, 10032, USA.
Background: Patients admitted to the intensive care unit (ICU) often have gut colonization with pathogenic bacteria and such colonization is associated with increased risk for death and infection. We conducted a trial to determine whether a prebiotic would improve the gut microbiome to decrease gut pathogen colonization and decrease downstream risk for infection among newly admitted medical ICU patients with sepsis.
Methods: This was a randomized, double-blind, placebo-controlled trial of adults who were admitted to the medical ICU for sepsis and were receiving broad-spectrum antibiotics.
PLoS One
January 2025
Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, United States of America.
Introduction: Respiratory syncytial virus (RSV) is the leading cause of hospitalization among US infants. Characterizing service utilization during infant RSV hospitalizations may provide important information for prioritizing resources and interventions.
Objective: The objective of this study was to describe the procedures and services received by infants hospitalized during their first RSV episode in their first RSV season, in addition to what proportion of infants died during this hospitalization.
Crit Care Med
November 2024
Department of Public Health Epidemiology, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
Objectives: Admission to ICU is associated with long-term consequences for the survivors. The study explores whether Danish ICU survivors remain employed after ICU discharge.
Design: A longitudinal register study of 16,284 Danish ICU survivors 25-67 years old 1:1 sex- and age-matched with general population references.
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