Incidence and outcomes of COVID-19-associated respiratory failure

INTRODUCTION: COVID-19 disease can cause severe acute respiratory failure (ARF) The disease is associated with significant morbidity and a mortality as high as 90% when ARF develops The aim of our research was to describe the characteristics and outcomes of COVID-19 associated respiratory failure in our patient population METHODS: This is a retrospective cohort study of COVID-19 positive patients admitted to Intensive Care Unit (ICU) at Anne Arundel Medical Center (AAMC) between March 2020 and June 2020 We collected baseline characteristics, respiratory data, interventions, and outcomes Descriptive statistics were implemented RESULTS: A total of 653 patients with confirmed COVID-19 were admitted to our hospital during the study period From them, 121 needed ICU: 109 (90 08%) had ARF, of which 91 required mechanical ventilation including 32 (29 35%) that met Acute Respiratory Distress Syndrome (ARDS) criteria, and 12 (9 91%) had other leading pathologies Median ventilator-days was 7 (3-15 75) 16 51% of the patients required High Flow Nasal cannula alone The median age of the patients with ARF was 64 (IQR 53 -73) years, sixtysix (60 55%) were men, and median BMI was 31 (25 31- 35 26), 33 02% identified themselves as caucasian, 29 35 % as African American, and remaining as other or declined to answer Median Sequential Organ Failure Assessment (SOFA) score on admission was 9 (IQR 5-12) and max SOFA score was 13 (9-14) The Severity of Illness (SOI) score was 4 (3-4) ICU median length of stay (LOS) was 9 (IQR 5-19) days, and median hospital LOS was 17 9 (8 9- 29 6) days 46 (42 02%) required vasopressors and 19 26% underwent dialysis On admission, 42 (38 53%) were treated for presumed co-existing bacterial pneumonia;10 (9 17%) had pneumothorax The ICU and hospital mortality rates were 41 28 % and 43 11% respectively CONCLUSIONS: In this cohort of COVID-19 patients, we observed a lower mortality rate in patient with ARF compared to available literature Adherence to evidence-based protocols, lower rate of transitioning to mechanical ventilation, and delivery of high-quality critical care could explain in part these results