60-day survival of critically ill COVID-19 first comers

Lang, Corinna Zotzmann V.; Schmid, B.; Berchtold-Herz, M.; Utzolino, S.; Biever, P. M.; Pottgießer, T.; Duerschmied, D.; Bode, C.; Wengenmayer, T.; Staudacher, D. L.

Background: Germany reported sufficient intensive care unit (ICU) resources throughout the first wave of coronavirus disease 2019 (COVID-19). The treatment of critically ill COVID-19 patients without rationing may improve the outcome. We therefore analyzed resources allocated to critically ill COVID-19 patients and their outcomes. Methods: : Retrospectively, we enrolled SARS-CoV2 PCR positive patients with respiratory failure from 03/08/2020 to 04/08/2020 and followed until 05/28/2020 in the university hospital of Freiburg, Germany. Results: : Thirty-four COVID-19 patients were admitted to the ICU in the defined interval with medium age of 67±13 (31-86) years. 6/34 (17.6%) were female. All patients suffered from moderate or severe acute respiratory distress syndrome (ARDS), 91.2% of the patients were intubated and 23.5% required extracorporeal membrane oxygenation (ECMO). Proning was performed in 67.6%, renal replacement therapy (RRT) was required in 35.3%. 96% required more than 20 nursing hours per day. Mean ICU stay was 21±19 (1-81) days. 60-day survival of critically ill COVID-19 patients was 50.0% (17/34). Causes of death were multi-organ failure (52.9%), refractory ARDS (17.6%) and intracerebral hemorrhage (17.6%). Conclusions: : Treatment of critically ill COVID-19 patients is protracted and resource intense. In a context without resources shortage, 50% of critically ill COVID-19 survived up to 60 days.