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

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ID: 104695
2020
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Abstract
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.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.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 patients 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.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.
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Authors Simone Piva, Matteo Filippini, Fabio Turla, Sergio Cattaneo, Alessio Margola, Silvia De Fulviis, Ida Nardiello, Alessandra Beretta, Laura Ferrari, Raffaella Trotta, Gloria Erbici, Emanuele Focà, Francesco Castelli, Frank Rasulo, Michael J Lanspa, Nicola Latronico
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Journal journal of critical care
Year 2020
DOI
S0883-9441(20)30547-5
URL
Keywords
covid-19 sars-cov-2 novel coronavirus

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