Severe COVID‐19 pneumonia in an intensive care setting and comparisons with historic severe viral pneumonia due to other viruses

Autor:	Kiran Dadhwal, Rosalind Stonham, Hannah Breen, Stephen Poole, Kordo Saeed, Ahilanandan Dushianthan
Rok vydání:	2022
Předmět:	Pulmonary and Respiratory Medicine medicine.medical_specialty Critical Care Coronavirus disease 2019 (COVID-19) SARS-CoV-2 business.industry Pneumonia Viral COVID-19 medicine.disease Respiration Artificial Intensive Care Units Pneumonia Intensive care Viral pneumonia medicine Humans Immunology and Allergy Obesity Intensive care medicine business Pandemics Genetics (clinical) Retrospective Studies
Zdroj:	The Clinical Respiratory Journal. 16:301-308
ISSN:	1752-699X 1752-6981
DOI:	10.1111/crj.13482
Popis:	Purpose: Severe viral pneumonia is associated with significant morbidity and mortality. Recent COVID-19 pandemic continues to impose significant health burden worldwide, and individual pandemic waves often lead to a large surge in the intensive care unit (ICU) admissions for respiratory support. Comparisons of severe SARS-CoV-2 pneumonia with other seasonal and nonseasonal severe viral infections are rarely studied in an intensive care setting. Methods: A retrospective cohort study comparing patients admitted to ICU with COVID-19 between March and June 2020 and those with viral pneumonias between January and December 2019. We compared patient specific demographic variables, duration of illness, ICU organ supportive measures and outcomes between both groups. Results: Analysis of 93 COVID-19 (Group 1) and 52 other viral pneumonia patients (Group 2) showed an increased proportion of obesity (42% vs. 23%, p = 0.02), non-White ethnicities (41% vs. 6%, p < 0.001) and diabetes mellitus (30% vs. 13%, p = 0.03) in Group 1, with lower prevalence of chronic obstructive pulmonary disease (COPD)/asthma (16% vs. 34%, p = 0.02). In Group 1, the neutrophil to lymphocyte ratio was much lower (6.7 vs. 10, p = 0.006), and invasive mechanical ventilation (58% vs. 26%, p < 0.001) was more common. Length of ICU (8 vs. 4, p < 0.001) and hospital stay (22 vs. 11, p < 0.001) was prolonged in Group 1, with no significant difference in mortality. Influenza A and rhinovirus were the most common pathogens in Group 2 (26% each). Conclusions: Key differences were identified within demographics (obesity, ethnicity, age, ICU scores, comorbidities) and organ support. Despite these variations, there were no significant differences in mortality between both groups. Further studies with larger sample sizes would allow for further assessment of clinical parameters in these patients.
Databáze:	OpenAIRE
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