ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019*

  1. Sara C. Auld
  2. Mark Caridi-Scheible
  3. James M. Blum
  4. Chad Robichaux
  5. Colleen Kraft
  6. Jesse T. Jacob
  7. Craig S. Jabaley
  8. David Carpenter
  9. Roberta Kaplow
  10. Alfonso C. Hernandez-Romieu
  11. Max W. Adelman
  12. Greg S. Martin
  13. Craig M. Coopersmith
  14. David J. Murphy

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Abstract

To determine mortality rates among adults with critical illness from coronavirus disease 2019.

Design:

Observational cohort study of patients admitted from March 6, 2020, to April 17, 2020.

Setting:

Six coronavirus disease 2019 designated ICUs at three hospitals within an academic health center network in Atlanta, Georgia, United States.

Patients:

Adults greater than or equal to 18 years old with confirmed severe acute respiratory syndrome-CoV-2 disease who were admitted to an ICU during the study period.

Interventions:

None.

Measurements and Main Results:

Among 217 critically ill patients, mortality for those who required mechanical ventilation was 35.7% (59/165), with 4.8% of patients (8/165) still on the ventilator at the time of this report. Overall mortality to date in this critically ill cohort is 30.9% (67/217) and 60.4% (131/217) patients have survived to hospital discharge. Mortality was significantly associated with older age, lower body mass index, chronic renal disease, higher Sequential Organ Failure Assessment score, lower Pa o 2 /F io 2 ratio, higher d -dimer, higher C-reactive protein, and receipt of mechanical ventilation, vasopressors, renal replacement therapy, or vasodilator therapy.

Conclusions:

Despite multiple reports of mortality rates exceeding 50% among critically ill adults with coronavirus disease 2019, particularly among those requiring mechanical ventilation, our early experience indicates that many patients survive their critical illness.

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  1. ScreenIT

    SciScore for 10.1101/2020.04.23.20076737: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This study was approved by the Emory University Institutional Review Board.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04280705CompletedAdaptive COVID-19 Treatment Trial (ACTT)

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1097/ccm.0000000000004457
  3. ScreenIT

    SciScore for 10.1101/2020.04.23.20076737: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementThis study was approved by the Emory University Institutional Review Board.Randomizationnot detected.Blindingnot detected.Power Analysisnot detected.Sex as a biological variableThere were 98 ( 45.2 % ) females and the majority of patients were black ( 153 [ 70.5 % ]) .

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Acknowledgements: We would like to extend our most profound thanks and gratitude to our colleagues in the Emory Critical Care Center and Emory Healthcare who have worked so hard to provide excellent clinical care during this global pandemic .
    Emory Healthcare
    suggested: (One Mind Biospecimen Bank Listing, SCR_004193)

    Results from OddPub: We did not find a statement about open data. We also did not find a statement about open code. Researchers are encouraged to share open data when possible (see Nature blog).

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, please follow this link.

  4. Version published to 10.1101/2020.04.23.20076737v1 on medRxiv