Clinical Characteristics and Outcomes of Critically Ill Patients with Novel Coronavirus Infectious Disease (COVID-19) In China: A Retrospective Multicenter Descriptive Study

Background: An ongoing outbreak of coronavirus disease 2019 (COVID-19) emerged in Wuhan since December 2019 and spread globally, however information about critically ill patients with COVID -19 is still limited. We aimed to describe the clinical characteristics and outcomes of critically ill patients with COVID-19 and figure out the risk factors of mortality. Methods: We extracted data retrospectively regarding 733 critically ill adult patients with laboratory-confirmed COVID-19 from 19 hospitals in China through January 1 to February 29, 2020. Demographic data, symptoms, laboratory values, comorbidities, treatments, and clinical outcomes were collected. The primary outcome was 28-day mortality. Data were compared between survivors and non-survivors. Findings: Of the 733 patients included in the study, the median (IQR) age was 65 (56-73) years and 256 (34.9%) were female. Among these patients, the median (IQR) APACHE II score was 10 (7 to 14) and 28-day mortality was 53.8%. Respiratory failure was the most common organ failure (597 [81.5%]), followed by shock (20.0%), thrombocytopenia (18.8%), central nervous system (8.6%) and renal dysfunction (8.0%). Multivariate Cox regression analysis showed that older age, male sex, malignancies, high APACHE II score, high LDH level, high D-dimer level, and low albumin level were independent risk factors of case fatality rate in critically ill patients with COVID-19. Interpretation: In this case series of critically ill patients with COVID-19 who were admitted into the ICU, more than half patients died at day 28. The higher percentage of organ failure in these patients indicated a significant demand for critical care resources. Funding Statement: This work were supported by Key Research and Development Plan of Jiangsu Province (BE2018743 and BE2019749) and Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (CIFMS) from Chinese Academy of Medical Sciences (2016-I2M-1-014) Declaration of Interests: All the authors declare no conflict of interest. Ethics Approval Statement: The study was approved by the ethics committee of Jin Yin-tan Hospital (KY-2020-10.02). The informed consent was waived due to the retrospective and observational nature of the study.