Characteristics and Outcomes of 21 Critically Ill Patients With #COVID-19 in Washington State

..A total of 21 cases were included (mean age, 70 years [range, 43-92 years]; 52% male). Comorbidities were identified in 18 cases (86%), with chronic kidney disease and congestive heart failure being the most common. Initial symptoms included shortness of breath (76%), fever (52%), and cough (48%) (Table 1). The mean onset of symptoms prior to presenting to the hospital was 3.5 days, and 17 patients (81%) were admitted to the ICU less than 24 hours after hospital admission.

An abnormal chest radiograph was observed in 20 patients (95%) at admission. The most common findings on initial radiograph were bilateral reticular nodular opacities (11 patients [52%]) and ground-glass opacities (10 [48%]). By 72 hours, 18 patients (86%) had bilateral reticular nodular opacities and 14 (67%) had evidence of ground-glass opacities. The mean white blood cell count was 9365 μL at admission and 14 patients (67%) had a white blood cell count in the normal range. Fourteen patients (67%) had an absolute lymphocyte count of less than 1000 cells/μL. Liver function tests were abnormal in 8 patients (38%) at admission (Table 1).

Mechanical ventilation was initiated in 15 patients (71%) (Table 2). Acute respiratory distress syndrome (ARDS) was observed in 15 of 15 patients (100%) requiring mechanical ventilation and 8 of 15 (53%) developed severe ARDS by 72 hours. Although most patients did not present with evidence of shock, vasopressors were used for 14 patients (67%) during the illness. Cardiomyopathy developed in 7 patients (33%). As of March 17, 2020, mortality was 67% and 24% of patients have remained critically ill and 9.5% have been discharged from the ICU..

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