Research & Article

Clinical presentation and initial management critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Brescia, Italy

ชื่อเรื่อง : Clinical presentation and initial management critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Brescia, Italy

ชื่อผู้แต่ง : Simone Piva, Matteo Filippini, Fabio Turla, Sergio Catteneo, Alessio Margola, Silvia De Fulviis, Ida Nardiello, Silvia Beretta, Laura Ferrari, Raffaella Trotta, Gloria Erbici, Emanuele Focà, Francesco Castelli, Frank Rasulo, Michael J. Lanspa, Nicola Latronico

สำนักพิมพ์ : ELSEVIER

เนื้อหาโดยย่อ : Abstract: Purpose
An ongoing pandemic of COVID-19 that started in Hubei, China has resulted in massive strain on the healthcare infrastructure in Lombardy, Italy. The management of these patients is still evolving.
Materials and methods
This is a single-center observational cohort study of critically ill patients infected with COVID-19. Bedside clinicians abstracted daily patient data on history, treatment, and short-term course. We describe management and a proposed severity scale for treatment used in this hospital.
Results
44 patients were enrolled; with incomplete information on 11. Of the 33 studied patients, 91% were male, median age 64; 88% were overweight or obese. 45% were hypertensive, 12% had been taking an ACE-inhibitor. Noninvasive ventilation was performed on 39% of patients for part or all or their ICU stay with no provider infection. Most patient received antibiotics for pneumonia. Patients also received lopinivir/ritonavir (82%), hydroxychloroquine (79%), and tocilizumab (12%) according to this treatment algorithm. Nine of 10 patients survived their ICU course and were transferred to the floor, with one dying in the ICU.
Conclusions
ICU patients with COVID-19 frequently have hypertension. Many could be managed with noninvasive ventilation, despite the risk of aerosolization. The use of a severity scale augmented clinician management.