Outcomes and clinical practice in patients with COVID-19 admitted to the intensive care unit in Montréal, Canada: a descriptive analysis

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Figure 1:
Disposition of 106 patients admitted to the intensive care unit with coronavirus disease 2019 pneumonia, by age.
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Figure 2:
Intubation status of 106 patients admitted to the intensive care unit with coronavirus disease 2019 pneumonia, by age.
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Figure 3:
Daily coronavirus disease 2019 (COVID-19) census. Note: ICU = intensive care unit, JGH = Jewish General Hospital.

Table 1:

Baseline demographic and clinical characteristics of patients admitted to the intensive care unit with coronavirus disease 2019 pneumonia

Characteristic	No. (%) of patients^* n = 106
Age, yr, median (IQR)	66 (54–74)
Sex, male	64 (60.4)
Body mass index, median (IQR), n = 76	29.4 (25.3–33.8)
Pregnant	3 (2.8)
“No intubation” advanced directive	8 (7.6)
Nursing home resident	11 (10.4)
Charlson Comorbidity Index score, median (IQR)	3 (1–4)
SOFA score,^† median (IQR)	5 (3–8)
APACHE II score, median (IQR)	15 (11–20)
Pao₂/Fio₂,^‡ median (IQR), n = 63	133 (95–174)
Comorbidities
Hypertension	55 (51.9)
Diabetes mellitus	30 (28.3)
Coronary artery disease	15 (14.2)
Obesity, n = 89	41 (46.1)
Chronic kidney disease	10 (9.4)
Chronic obstructive lung disease	8 (7.6)
Asthma	10 (9.4)
Malignancy	10 (9.4)
Immunocompromised^§	12 (11.3)

Note: APACHE II = Acute Physiology And Chronic Health Evaluation II, Fio₂ = fraction of inspired oxygen, IQR = interquartile range, Pao₂ = partial pressure of oxygen, SOFA = Sequential Organ Failure Assessment.
↵* Unless stated otherwise.
↵† SOFA score excluding the neurologic component; worst SOFA score calculated after 24 h of admission.
↵‡ Worst Pao₂/FiO₂ calculated 24 h postintubation.
↵§ Diagnosis of HIV or treatment with chronic corticosteroid, chemotherapy or biologic medication.

Table 2:

Critical care management of patients admitted to the intensive care unit with coronavirus disease 2019 pneumonia

Intervention	No. (%) of patients^* n = 106
Respiratory management
Invasive mechanical ventilation	65 (61.3)
High PEEP^†	22 (33.9)
PEEP at 24 h postintubation, median (IQR), cm H₂O, n = 63	10 (8–12)
Prone positioning	29 (27.4)
Intubated	19 (65.5)
Not intubated	10 (34.5)
HFNC	51 (48.1)
Initial respiratory support^‡	29 (56.9)
Postextubation support	24 (47.1)
Medication
Neuromuscular blockade	24 (22.6)
Corticosteroids	53 (50.0)
Symptom onset to receipt of corticosteroids, d, median (IQR)	13 (10–17)
Azithromycin	94 (88.7)
Hydroxychloroquine	75 (70.8)
Tocilizumab	11 (10.4)
Oseltamivir	8 (7.5)
Lopinavir–ritonavir	6 (5.7)

Note: HFNC = high-flow nasal cannula, IQR = interquartile range, PEEP = positive end-expiratory pressure.
↵* Unless stated otherwise.
↵† High PEEP defined as PEEP > 15 cm H₂O during mechanical ventilation.
↵‡ Two patients had HFNC for both indications.

Table 3:

Outcomes and complications in critically ill patients with coronavirus disease 2019 pneumonia

Variable	No. (%) of patients^* n = 106
Outcomes
Hospital mortality	21 (19.8)
ICU mortality	18 (17.0)
ICU mortality in mechanically ventilated patients, n = 65	12 (18.5)
Currently on medical ward^†	4 (3.8)
Duration of mechanical ventilation, d, median (IQR)	12 (8–18)
ICU length of stay, d, median (IQR)	10 (4–17)
Hospital length of stay, d, median (IQR)	19 (10–31)
Tracheostomy	7 (6.6)
Complications
ICU-acquired infection^‡	22 (20.8)
Atrial fibrillation	24 (22.6)
Acute kidney injury^§	20 (18.9)
Renal replacement therapy	12 (11.3)
Thrombotic events^¶	16 (15.1)
Pulmonary embolism or deep vein thrombosis	12 (11.3)
Ischemic stroke	7 (6.6)
Peripheral arterial thrombosis	1 (0.9)

Note: ICU = intensive care unit, IQR = interquartile range.
↵* Unless stated otherwise.
↵† Two patients awaiting rehabilitation and 2 patients awaiting long-term care.
↵‡ Positive culture results with pathogenic organisms.
↵§ Greater than 2 times baseline creatinine.
↵¶ Thromboembolic event confirmed by imaging; 2 patients had > 1 thrombotic events.