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Open Access 01-12-2020 | Acute Kidney Injury | Research

Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China

Authors: Jiqian Xu, Xiaobo Yang, Luyu Yang, Xiaojing Zou, Yaxin Wang, Yongran Wu, Ting Zhou, Yin Yuan, Hong Qi, Shouzhi Fu, Hong Liu, Jia’an Xia, Zhengqin Xu, Yuan Yu, Ruiting Li, Yaqi Ouyang, Rui Wang, Lehao Ren, Yingying Hu, Dan Xu, Xin Zhao, Shiying Yuan, Dingyu Zhang, You Shang

Published in: Critical Care | Issue 1/2020

Abstract

Background

The global numbers of confirmed cases and deceased critically ill patients with COVID-19 are increasing. However, the clinical course, and the 60-day mortality and its predictors in critically ill patients have not been fully elucidated. The aim of this study is to identify the clinical course, and 60-day mortality and its predictors in critically ill patients with COVID-19.

Methods

Critically ill adult patients admitted to intensive care units (ICUs) from 3 hospitals in Wuhan, China, were included. Data on demographic information, preexisting comorbidities, laboratory findings at ICU admission, treatments, clinical outcomes, and results of SARS-CoV-2 RNA tests and of serum SARS-CoV-2 IgM were collected including the duration between symptom onset and negative conversion of SARS-CoV-2 RNA.

Results

Of 1748 patients with COVID-19, 239 (13.7%) critically ill patients were included. Complications included acute respiratory distress syndrome (ARDS) in 164 (68.6%) patients, coagulopathy in 150 (62.7%) patients, acute cardiac injury in 103 (43.1%) patients, and acute kidney injury (AKI) in 119 (49.8%) patients, which occurred 15.5 days, 17 days, 18.5 days, and 19 days after the symptom onset, respectively. The median duration of the negative conversion of SARS-CoV-2 RNA was 30 (range 6–81) days in 49 critically ill survivors that were identified. A total of 147 (61.5%) patients deceased by 60 days after ICU admission. The median duration between ICU admission and decease was 12 (range 3–36). Cox proportional-hazards regression analysis revealed that age older than 65 years, thrombocytopenia at ICU admission, ARDS, and AKI independently predicted the 60-day mortality.

Conclusions

Severe complications are common and the 60-day mortality of critically ill patients with COVID-19 is considerably high. The duration of the negative conversion of SARS-CoV-2 RNA and its association with the severity of critically ill patients with COVID-19 should be seriously considered and further studied.

Available only for authorised users

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Title: Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China
Authors: Jiqian Xu
Xiaobo Yang
Luyu Yang
Xiaojing Zou
Yaxin Wang
Yongran Wu
Ting Zhou
Yin Yuan
Hong Qi
Shouzhi Fu
Hong Liu
Jia’an Xia
Zhengqin Xu
Yuan Yu
Ruiting Li
Yaqi Ouyang
Rui Wang
Lehao Ren
Yingying Hu
Dan Xu
Xin Zhao
Shiying Yuan
Dingyu Zhang
You Shang
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Acute Kidney Injury
SARS-CoV-2
Thrombocytopenia
Acute Respiratory Distress-Syndrome
COVID-19
Acute Kidney Injury
Published in: Critical Care / Issue 1/2020
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-020-03098-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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