Clinical Characteristics and Current Treatment of Critically Ill Patients with COVID-19 Outside Wuhan, China: A Multicenter, Retrospective, Observational Study
28 Pages Posted: 23 Mar 2020More...
Backgrounds: A novel coronavirus disease 2019 (COVID-19) occurred in Wuhan and rapidly spread elsewhere. The clinical characteristics and treatment of critical ill patients outside Wuhan remain unknown. We aimed to describe the epidemiology and treatment of critical ill patients with COVID-19 in Hebei province.
Methods: All patients were from designated hospitals of Hebei province and fit the criteria. We collected the clinical data, laboratory examinations and treatment of all participants.
Findings: By 14 February 2020, 37 critical ill patients were included. The mean age of the patients was 58·73 (SD 13·76) years, 21 (56·80%) patients were men, 18 (48·60%) were familial cluster, 26 (70·30%) patients had chronic illness. The patients with critical type had a longer period of confirmation time, more severe inflammation and lung injury, a lower lymphocyte percentage. All patients were treated with antiviral agents, 33 (89·20%) with antibacterial agents, 35 (95·60%) patients with methylprednisolone and traditional Chinese drugs. Nine (60·00%) patients with critical type were treated with invasive mechanical ventilation, 9 (60·00%) of those with complications. The patients with critical type received more fluid and more diuretics.
Interpretation: Patients with underlying disease and the confirmation time > 10 days were more likely to develop to critical type. The critical type patients had higher risk of infection, respiratory depression, circulatory collapse, and complications. The strategy of lung-protective mechanical ventilation and restrictive fluid management should be strictly followed.
Funding Statement: This study was supported by the Department of Science and Technology of Hebei Province of China (20277707D).
Declaration of Interests: The authors declare that there are no conflicts of interests regarding the publication of this paper.
Ethics Approval Statement: The Ethics Commission of the Fourth Clinical Medical College of Hebei Medical University approved this study (2020KS002).
Keywords: COVID-19, 2019 novel coronavirus, 2019-nCoV, SARS-CoV-2, critical ill patients
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