COVID-19: common reasons for ICU admission

Hypoxemic respiratory failure leading to mechanical ventilation, hypotension requiring vasopressor treatment, or both, are the most common reasons for admission to the intensive care unit (ICU), according a study published in the New England Journal of Medicine on the community transmission of Covid-19 in the US.

The paper, Covid-19 in Critically Ill Patients in the Seattle Region — Case Series, looks at 24 patients from nine Seattle-area hospitals who were admitted to the ICU with confirmed infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in February this year.

The most common symptoms were cough and shortness of breath, and 50% of patients had fever on admission, and 58% had diabetes mellitus. All patients were admitted for hypoxemic respiratory failure; 75% needed mechanical ventilation, and most of the patients also had hypotension and needed vasopressors.

Unfortunately, mortality among these critically ill patients was high. Half the patients (12) died between ICU day one and day 18, including four patients who had a do-not-resuscitate order on admission.

Of the 12 surviving patients, five were discharged home, four were discharged from the ICU but remained in the hospital, and three continued to receive mechanical ventilation in the ICU.

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