Published online Nov 9, 2021. doi: 10.5492/wjccm.v10.i6.369
Peer-review started: June 24, 2021
First decision: July 27, 2021
Revised: August 5, 2021
Accepted: September 16, 2021
Article in press: September 16, 2021
Published online: November 9, 2021
Processing time: 133 Days and 15.7 Hours
There is limited data on the difference in the clinical characteristics and outcomes of patients with severe coronavirus disease 2019 (COVID-19) infection in the summer compared to the fall surge.
To compare the sociodemographic, clinical characteristics, and outcomes among mechanically ventilated patients with severe COVID-19 infection admitted to the intensive care unit (ICU) during the summer and fall surges in the year 2020.
We included patients admitted to the ICU and treated with invasive mechanical ventilation for COVID-19 associated respiratory failure between April 1 and December 31, 2020. Patients were categorized into summer surge for ICU admissions between June 15, 2020, and August 15, 2020, and fall surge between October 15, 2020, and December 31, 2020. We compared patients' characteristics and outcomes using descriptive and inferential statistics.
A total of 220 patients were admitted to the Grady Memorial Hospital ICU and mechanically ventilated for COVID-19 associated hypoxemic respiratory failure during the period considered (125 during the summer surge and 95 during the fall surge). More women were admitted in the fall compared to summer (41.1% vs 36.8%, difference, 4.3%; 95%CI: 1.2, 7.5). Patients admitted in the fall had fewer comorbidities (chronic obstructive pulmonary disease, stroke, diabetes mellitus, obstructive sleep apnea and body mass index ≥ 35 kg/m2). Overall, patients in the fall had a lower ICU mortality rate (27.4% vs 38.4%, difference, -11.0; 95%CI: -6.4, -18.2), shorter length of stay on the mechanical ventilator (7 d vs 11 d, difference, 4 d; 95%CI: 2.1, 6.6) and shorter ICU length of stay (9 d vs 14 d, difference, 5 d; 95%CI: 2.7, 9.4).
Patients admitted with severe COVID-19 infection requiring mechanical ventilation had better outcomes in the fall than summer. This difference observed is likely attributable to a better understanding of the condition and advances in treatment strategies.
Core Tip: In this observational study, we compared the sociodemographic, clinical characteristics, and outcomes among mechanically ventilated patients with coronavirus disease 2019 (COVID-19) infection admitted to the intensive care unit (ICU) during the summer and fall surges in the year 2020. Compared to patients admitted with severe COVID-19 in the summer, those in the fall had better outcomes including decreased mortality and low length of stay in the ICU. This is likely due to the improved understanding of COVID-19 and the advances in treatment strategies.