Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 7, 2020
Date Accepted: Feb 17, 2021
Date Submitted to PubMed: Mar 10, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Early Improvement of Acute Respiratory Distress Syndrome in Patients with COVID-19: Insights from the Data of ICU Patients in Chongqing, China
ABSTRACT
Background:
This study aimed to describe the clinical features, outcomes, and acute respiratory distress syndrome (ARDS) characteristics of patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU) in Chongqing, China.
Methods:
The epidemiology of COVID-19 in Chongqing, China, was analyzed retrospectively, and 75 ICU patients from 2 hospitals were included in this study. On day 1, 56 patients with ARDS were selected for subgroup analysis, and bivariate analysis was performed to identify predictors for early improvement of ARDS (eiARDS).
Results:
Chongqing reported a 5.3% case fatality rate of the 75 ICU patients. The median age of the ICU patients was 57 years (interquartile range, 25–75), and no bias was obtained in the sex ratio. A total of 93% of patients developed ARDS during ICU stay, and more than half had moderate ARDS. However, most of the patients (55%) were supported with high-flow nasal cannula oxygen therapy, but not mechanical ventilation. Nearly one third of patients with ARDS improved (arterial blood oxygen partial pressure/oxygen concentration >300 mm Hg) in 1 week, which was defined as eiARDS. Patients with eiARDS had a higher survival rate and lower length of ICU stay than those with “non-eiARDS”. Age (<55 years) was the only variable independently associated with eiARDS, with an odds ratio of 7.4.
Conclusions:
eiARDS was common in patients with COVID-19, and predicted a favorable clinical outcome. Age (<55 years) was an independent predictor of eiARDS, and stratification of patients with COVID-19 by age was recommended.
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