From: Timing and causes of death in severe COVID-19 patients
COVID-19-related MODS (n = 35) | Secondary infection-related MODS (n = 24) | Refractory hypoxemia (n = 18) | Fatal ischemic event (n = 13) | Others* (n = 3) | p | |
---|---|---|---|---|---|---|
Age, years | 71 [63–76] | 66 [62–71] | 670 [62–77] | 61 [56–74] | 60 [51–64] | 0.14 |
Female gender | 7 (20) | 3 (12.5) | 2 (11.1) | 3 (23.1) | 0 (0) | 0.74 |
Body mass index | 29 [26–32] | 28 [26–30] | 26 [24–29] | 28 [27–31] | 32 [28–32] | 0.52 |
Comorbid conditions | ||||||
Obesity | 21 (63.6) | 11 (45.8) | 10 (62.5) | 8 (61.5) | 2 (66.7) | 0.70 |
Arterial hypertension | 18 (51.4) | 11 (45.8) | 11 (61.1) | 7 (53.8) | 1 (33.3) | 0.84 |
Diabetes mellitus | 13 (37.1) | 8 (33.3) | 5 (27.8) | 4 (30.8) | 0 (0) | 0.74 |
Tobacco use | 6 (17.1) | 3 (12.5) | 2 (11.1) | 1 (7.7) | 0 (0) | 0.85 |
COPD | 3 (8.6) | 6 (25.0) | 2 (11.1) | 1 (7.7) | 0 (0) | 0.34 |
Chronic kidney disease | 5 (14.3) | 3 (12.5) | 3 (16.7) | 0 (0) | 0 (0) | 0.60 |
Cirrhosis | 0 (0) | 1 (4.2) | 0 (0) | 0 (0) | 0 (0) | 0.57 |
Characteristics on ICU admission | ||||||
SAPS2, points | 47 [38–63] | 47 [43–60] | 50 [38–63] | 42 [27–65] | 32 [26–58] | 0.78 |
SOFA, points | 8 [5–11] | 8 [6–11] | 8 [5–9] | 8 [6–10] | 9 [6–9] | 0.85 |
Initial P/F ratio | 100 [70–147] | 80 [72–87] | 79 [65–120] | 106 [70–190] | 98 [84–144] | 0.58 |
Interval from symptom onset to ICU admission | 7 [4–9] | 7 [5–9] | 8 [5–10] | 10 [7–10] | 8 [6–9] | 0.66 |
ICU management | ||||||
Mechanical ventilation | 35 (100) | 23 (95.8) | 18 (100) | 13 (100) | 3 (100) | 0.57 |
Norepinephrine | 35 (100) | 23 (95.8) | 15 (83.3) | 11 (84.6) | 3 (100) | 0.11 |
Neuromuscular blockade | 35 (100) | 24 (100) | 15 (83.3) | 13 (100) | 3 (100) | 0.01 |
Prone positioning | 31 (88.6) | 22 (91.7) | 14 (77.8) | 11 (84.6) | 3 (100) | 0.66 |
Extracorporeal membrane oxygenation | 3 (8.8) | 5 (22.7) | 2 (11.1) | 3 (25) | 1 (33.3) | 0.43 |
Renal replacement therapy | 18 (51.4) | 16 (66.7) | 4 (22.2) | 5 (38.5) | 1 (33.3) | 0.06 |
Specific treatment | ||||||
Hydroxychloroquine | 12 (34.3) | 10 (41.7) | 3 (17.6) | 2 (15.4) | 2 (66.7) | 0.19 |
Azithromycin | 10 (28.6) | 11 (45.8) | 3 (17.6) | 2 (15.4) | 1 (33.3) | 0.24 |
Lopinavir/ritonavir | 13 (37.1) | 6 (25) | 4 (23.5) | 3 (23.1) | 2 (66.7) | 0.46 |
Corticosteroids | 12 (35.3) | 6 (27.3) | 2 (11.8) | 3 (25) | 1 (33.3) | 0.52 |
Tocilizumab | 2 (5.7) | 2 (8.3) | 1 (5.9) | 0 (0) | 0 (0) | 0.86 |
Remdesivir | 0 (0) | 1 (4.2) | 0 (0) | 0 (0) | 0 (0) | 0.57 |
Outcomes | ||||||
Length of stay, days | 14 [7–24] | 20 [9–30] | 12 [9–27] | 16 [6–27] | 31 [18–32] | 0.60 |
End-of-life decisions | 17 (48.6) | 4 (16.7) | 15 (83.3) | 4 (30.8) | 2 (66.7) | < 0.01 |