COVID-19 in London, a Case Series Demonstrating Late Improvement in Survivors

Al-Hindawi, A.; Sokhi, J.; Cuddihy, J.; Lockie, C.; Christie, L.; Davies, R.; Singh, S.; Vizcaychipi, M.; Hayes, M.; Sisson, A.; Keays, R.

Objective To determine whether the trajectories of survivors and non-survivors are different in patients admitted to intensive care in London. Design In this case series of 15 survivors and 16 non-survivors, data from admission to discharge was collected and aligned to lowest PaO2/FiO2 ratio where aggregation and trends were demonstrated. Setting Single centre case-series in London, Intensive Care. Participants All non-survivors were included (n=16). A biased set of survivors (n=15) who were demonstrated an unexpected and rapid recovery after a prolonged period of mechanical ventilatory support. Results Respiratory failure trajectories of survivors and non-survivors were similar once aligned indicating, from a respiratory function perspective, it is difficult to identify survivors from non-survivors with some survivors improving late in their disease (day 20 - 30 from symptom onset) Non-survivors are admitted earlier in their disease (p < 0.05) and had worse organ failure requirements prior to the nadir of their respiratory funciton (p < 0.05) compard to survivors. Conclusion Analysis of multiple factors fails to differentiate between survivors and non-survivors. Even when faced with multiorgan failure, perseverance until discharge must be advocated as late improvements do occur in survivors.