Clinical Characteristics and Evolution of Ventilated Patients Invasively During the First Year of COVID-19 - Descriptive-Observational Study at a Public-School Hospital of Buenos Aires, Argentina

*Camila S Galeano
Division Of Kinesiology Physiatry And Rehabilitation, Hospital De Clínicas “José De San Martín”, Buenos Aires, Argentina

*Corresponding Author:
Camila S Galeano
Division Of Kinesiology Physiatry And Rehabilitation, Hospital De Clínicas “José De San Martín”, Buenos Aires, Argentina
Email:camila.s.galeano@gmail.com

Published on: 2022-07-11

Abstract

Introduction: SARS CoV-2 infection can cause mild respiratory symptoms to acute respiratory failure, characterized by severe hypoxemia and bilateral infiltrates that require intensive care. Being a new entity with little knowledge in our country, we sought to describe the epidemiological and clinical characteristics, as well as the mortality of patients with mechanical ventilation diagnosed with COVID-19 infection admitted to the Intensive Care Unit (ICU).
Methods: We conducted a retrospective, observational, descriptive study that included patients over 18 years, diagnosed with COVID-19 infection that required invasive mechanical ventilation at the Intensive Care Unit of the Hospital de Clínicas “José de San Martín” in Buenos Aires City during the period between March 25, 2020, and March 25, 2021. Patients under 18 years of age and those who received IMV for more than 24 hours before admission to the ICU were excluded from the study.
Results: 128 patients underwent invasive mechanical ventilation throughout the study time with 60.94% mortality. The median age was 68 years old (57-76) and the majority were male (57.03%). History of cardiac hypertension was the most commonly found comorbidity (67.94%), followed by diabetes and obesity (23.43%). The Median for the APACHE II score was 14 at ICU admission (10-18). The time from symptoms to IMV was 7 days (4-11). The median days of IMV were 14 days (7, 5-23) and the median ICU stay was 16 days (10, 75-26).
Conclusion: This study will allow us to know the epidemiological, clinical and mortality characteristics during the first year of the pandemic, which could facilitate the planning of future therapeutic strategies and the use of resources. Randomized prospective studies are needed to gain more knowledge about the approach to this population.

Keywords

Acute Respiratory Distress Syndrome; Coronavirus; Mechanical Ventilation; Critical Care

Introduction

On December 31, 2019, a series of cases of pneumonia of unknown origin in the city of Wuhan, China was reported. On February 11, 2020, the disease-causing agent called Sars COV-2 was identified [1]. This was isolated from biological samples and identified as the Beta Coronavirus genus, placing it with others such as severe acute respiratory syndrome and the Middle East Respiratory Syndrome [2]. Infection by the Sars Virus COV-2 can cause slight respiratory symptoms to picture Acute respiratory failure, characterized by severe hypoxemia and bilateral infiltrates, requiring intensive care [3].
The World Health Organization (WHO) declared Pandemia on January 30, 2020, confirming Argentina the first case on March 3 of the same year [4]. At the end of the study period, 2,291,051 cases with more than 55,000 deaths in the country. This situation led to the limit of health resources, reaching August 2020 a percentage of the ECI beds of almost 70% [5,6].
Numerous international studies reported data from patients affected by this pathology, in terms of its characteristics and evolution of it. However, in our country, the information is scarce, so observing the characteristics and evolution of patients admitted to the UTI of the José de San Martin Hospital (HCJSM) could facilitate the planning of future therapeutic strategies and the use of resources.
Therefore, the objective of this work is to describe the epidemiological, clinical and mortality characteristics of ventilated patients invasively diagnosed with COVID-19 and admitted to the UTI of the HCJSM in the period between March 25, 2020, and March 25, 2021.

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