Characteristics and outcomes of patients infected with nCoV19 requiring invasive mechanical ventilation in Argentina

Abstract Objective: A novel coronavirus emerged this year as a cause of viral pneumonia. The main characteristics of the virus are rapid transmission, high contagion capacity and potential severity. The objective of this case series study is to describe the clinical characteristics of patients with confirmed coronavirus disease (COVID-19) admitted to different intensive care units in Argentina for mechanical ventilation. Methods: A descriptive, prospective, multicenter case series study was conducted between April 1 and May 8, 2020. Data from patients older than 18 years who were admitted to the intensive care unit for mechanical ventilation for acute respiratory failure with a positive diagnosis of COVID-19 were included. Results: The variables for 47 patients from 31 intensive care units were recorded: 78.7% were men (median age of 61 years), with a SAPS II score of 43 and a Charlson index score of 3. The initial ventilatory mode was volume control - continuous mandatory ventilation with a tidal volume less than 8mL/kg in 100% of cases, with a median positive end-expiratory pressure of 10.5cmH2O. At the end of the study, 29 patients died, 8 were discharged, and 10 remained hospitalized. The SAPS II score was higher among patients who died (p = 0.046). Charlson comorbidity index was associated with higher mortality (OR = 2.27, 95% CI 1.13 - 4.55, p = 0.02). Conclusion: Patients with COVID-19 and on mechanical ventilation in this series presented clinical variables similar to those described to date in other international reports. Our findings provide data that may predict outcomes.

摘要：
研究目的：今年出现了一种引发病毒性肺炎的新型冠状病毒。该病毒的主要特征为传播速度快、传染能力强且具有潜在重症风险。本病例系列研究旨在描述阿根廷不同重症监护病房收治的、需接受机械通气的新型冠状病毒肺炎（COVID-19）确诊患者的临床特征。
研究方法：本研究为描述性、前瞻性、多中心病例系列研究，实施周期为2020年4月1日至5月8日。纳入对象为年龄18周岁以上、因急性呼吸衰竭入住重症监护病房接受机械通气且新冠病毒检测结果呈阳性的COVID-19确诊患者。
研究结果：共收集到来自31个重症监护病房的47例患者的临床数据：其中78.7%为男性，中位年龄为61岁，简化急性生理学评分II（SAPS II）为43分，查尔森合并症指数（Charlson index）为3分。所有患者的初始通气模式均为容量控制-持续指令通气，潮气量均低于8mL/kg，中位呼气末正压为10.5cmH₂O。研究结束时，29例患者死亡，8例患者出院，10例仍住院治疗。死亡患者的SAPS II评分更高（p=0.046）。查尔森合并症指数与更高的死亡率相关（优势比OR=2.27，95%置信区间CI：1.13~4.55，p=0.02）。
研究结论：本病例系列中接受机械通气的COVID-19患者，其临床特征与目前其他国际报道中描述的结果相似。本研究结果可为预测患者预后提供数据依据。