Bhatraju 2020 N Engl J Med
|Bhatraju Pavan K, Ghassemieh Bijan J, Nichols Michelle, Kim Richard, Jerome Keith R, Nalla Arun K, Greninger Alexander L, Pipavath Sudhakar, Wurfel Mark M, Evans Laura, Kritek Patricia A, West T Eoin, Luks Andrew, Gerbino Anthony, Dale Chris R, Goldman Jason D, O’Mahony Shane, Mikacenic Carmen (2020) Covid-19 in critically ill patients in the Seattle region - case series. N Engl J Med 2020;NEJMoa2004500 [published online ahead of print, 2020 Mar 30].|
Bhatraju Pavan K, Ghassemieh Bijan J, Nichols Michelle, Kim Richard, Jerome Keith R, Nalla Arun K, Greninger Alexander L, Pipavath Sudhakar, Wurfel Mark M, Evans Laura, Kritek Patricia A, West T Eoin, Luks Andrew, Gerbino Anthony, Dale Chris R, Goldman Jason D, O’Mahony Shane, Mikacenic Carmen (2020) N Engl J Med
Abstract: Background: Community transmission of coronavirus 2019 (Covid-19) was detected in the state of Washington in February 2020.
Methods: We identified patients from nine Seattle-area hospitals who were admitted to the intensive care unit (ICU) with confirmed infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Clinical data were obtained through review of medical records. The data reported here are those available through March 23, 2020. Each patient had at least 14 days of follow-up.
Results: We identified 24 patients with confirmed Covid-19. The mean (±SD) age of the patients was 64±18 years, 63 % were men, and symptoms began 7±4 days before admission. The most common symptoms were cough and shortness of breath; 50 % of patients had fever on admission, and 58 % had diabetes mellitus. All the patients were admitted for hypoxemic respiratory failure; 75 % (18 patients) needed mechanical ventilation. Most of the patients (17) also had hypotension and needed vasopressors. No patient tested positive for influenza A, influenza B, or other respiratory viruses. Half the patients (12) died between ICU day 1 and day 18, including 4 patients who had a do-not-resuscitate order on admission. Of the 12 surviving patients, 5 were discharged home, 4 were discharged from the ICU but remained in the hospital, and 3 continued to receive mechanical ventilation in the ICU.
Conclusions: During the first 3 weeks of the Covid-19 outbreak in the Seattle area, the most common reasons for admission to the ICU were hypoxemic respiratory failure leading to mechanical ventilation, hypotension requiring vasopressor treatment, or both. Mortality among these critically ill patients was high. (Funded by the National Institutes of Health.).
• Bioblast editor: Gnaiger E
Labels: MiParea: Gender, Patients Pathology: Infectious, Obesity
Preparation: Intact organism
Comorbidity, BMI, mitObesity2020, Virus
- Stefan 2020 Nat Rev Endocrinol: "A descriptive study of a small sample of 24 (63 % were men) critically ill patients diagnosed with COVID-19 in the Seattle region was among the first to report BMI data (3 patients with a BMI in the normal category, 7 with overweight, 13 with obesity and 1 with missing data). Although the numbers are too small for meaningful statistical analyses, 85 % of the patients with obesity required mechanical ventilation and 62 % of the patients with obesity died. These proportions are greater than those in the patients without obesity, in which 64 % required mechanical ventilation and 36 % died" (refering to the above publication).