Outcomes of mechanically ventilated patients with COVID-19 associated respiratory failure.
Identifieur interne : 000106 ( Main/Exploration ); précédent : 000105; suivant : 000107Outcomes of mechanically ventilated patients with COVID-19 associated respiratory failure.
Auteurs : Christopher S. King [États-Unis] ; Dhwani Sahjwani [États-Unis] ; A Whitney Brown [États-Unis] ; Saad Feroz [États-Unis] ; Paula Cameron [États-Unis] ; Erik Osborn [États-Unis] ; Mehul Desai [États-Unis] ; Svetolik Djurkovic [États-Unis] ; Aditya Kasarabada [États-Unis] ; Rachel Hinerman [États-Unis] ; James Lantry [États-Unis] ; Oksana A. Shlobin [États-Unis] ; Kareem Ahmad [États-Unis] ; Vikramjit Khangoora [États-Unis] ; Shambhu Aryal [États-Unis] ; A Claire Collins [États-Unis] ; Alan Speir [États-Unis] ; Steven Nathan [États-Unis]Source :
- PloS one [ 1932-6203 ] ; 2020.
Abstract
PURPOSE
The outcomes of patients requiring invasive mechanical ventilation for COVID-19 remain poorly defined. We sought to determine clinical characteristics and outcomes of patients with COVID-19 managed with invasive mechanical ventilation in an appropriately resourced US health care system.
METHODS
Outcomes of COVID-19 infected patients requiring mechanical ventilation treated within the Inova Health System between March 5, 2020 and April 26, 2020 were evaluated through an electronic medical record review.
RESULTS
1023 COVID-19 positive patients were admitted to the Inova Health System during the study period. Of these, 164 (16.0%) were managed with invasive mechanical ventilation. All patients were followed to definitive disposition. 70/164 patients (42.7%) had died and 94/164 (57.3%) were still alive. Deceased patients were older (median age of 66 vs. 55, p <0.0001) and had a higher initial d-dimer (2.22 vs. 1.31, p = 0.005) and peak ferritin levels (2998 vs. 2077, p = 0.016) compared to survivors. 84.3% of patients over 70 years old died in the hospital. Conversely, 67.4% of patients age 70 or younger survived to hospital discharge. Younger age, non-Caucasian race and treatment at a tertiary care center were all associated with survivor status.
CONCLUSION
Mortality of patients with COVID-19 requiring invasive mechanical ventilation is high, with particularly daunting mortality seen in patients of advanced age, even in a well-resourced health care system. A substantial proportion of patients requiring invasive mechanical ventilation were not of advanced age, and this group had a reasonable chance for recovery.
DOI: 10.1371/journal.pone.0242651
PubMed: 33227024
PubMed Central: PMC7682899
Affiliations:
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King</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Sahjwani, Dhwani" sort="Sahjwani, Dhwani" uniqKey="Sahjwani D" first="Dhwani" last="Sahjwani">Dhwani Sahjwani</name><affiliation wicri:level="2"><nlm:affiliation>Department of Pediatrics, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pediatrics, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Brown, A Whitney" sort="Brown, A Whitney" uniqKey="Brown A" first="A Whitney" last="Brown">A Whitney Brown</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Feroz, Saad" sort="Feroz, Saad" uniqKey="Feroz S" first="Saad" last="Feroz">Saad Feroz</name><affiliation wicri:level="2"><nlm:affiliation>Department of Pediatrics, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pediatrics, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region 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Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Desai, Mehul" sort="Desai, Mehul" uniqKey="Desai M" first="Mehul" last="Desai">Mehul Desai</name><affiliation wicri:level="2"><nlm:affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Djurkovic, Svetolik" sort="Djurkovic, Svetolik" uniqKey="Djurkovic S" first="Svetolik" last="Djurkovic">Svetolik Djurkovic</name><affiliation wicri:level="2"><nlm:affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Kasarabada, Aditya" sort="Kasarabada, Aditya" uniqKey="Kasarabada A" first="Aditya" last="Kasarabada">Aditya Kasarabada</name><affiliation wicri:level="2"><nlm:affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Hinerman, Rachel" sort="Hinerman, Rachel" uniqKey="Hinerman R" first="Rachel" last="Hinerman">Rachel Hinerman</name><affiliation wicri:level="2"><nlm:affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Lantry, James" sort="Lantry, James" uniqKey="Lantry J" first="James" last="Lantry">James Lantry</name><affiliation wicri:level="2"><nlm:affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Shlobin, Oksana A" sort="Shlobin, Oksana A" uniqKey="Shlobin O" first="Oksana A" last="Shlobin">Oksana A. Shlobin</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Ahmad, Kareem" sort="Ahmad, Kareem" uniqKey="Ahmad K" first="Kareem" last="Ahmad">Kareem Ahmad</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Khangoora, Vikramjit" sort="Khangoora, Vikramjit" uniqKey="Khangoora V" first="Vikramjit" last="Khangoora">Vikramjit Khangoora</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Aryal, Shambhu" sort="Aryal, Shambhu" uniqKey="Aryal S" first="Shambhu" last="Aryal">Shambhu Aryal</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Collins, A Claire" sort="Collins, A Claire" uniqKey="Collins A" first="A Claire" last="Collins">A Claire Collins</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease Research, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease Research, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Speir, Alan" sort="Speir, Alan" uniqKey="Speir A" first="Alan" last="Speir">Alan Speir</name><affiliation wicri:level="2"><nlm:affiliation>Department of Cardiothoracic Surgery, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Cardiothoracic Surgery, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Nathan, Steven" sort="Nathan, Steven" uniqKey="Nathan S" first="Steven" last="Nathan">Steven Nathan</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:33227024</idno><idno type="pmid">33227024</idno><idno type="doi">10.1371/journal.pone.0242651</idno><idno type="pmc">PMC7682899</idno><idno type="wicri:Area/Main/Corpus">000025</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000025</idno><idno type="wicri:Area/Main/Curation">000025</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000025</idno><idno type="wicri:Area/Main/Exploration">000025</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Outcomes of mechanically ventilated patients with COVID-19 associated respiratory failure.</title><author><name sortKey="King, Christopher S" sort="King, Christopher S" uniqKey="King C" first="Christopher S" last="King">Christopher S. King</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Sahjwani, Dhwani" sort="Sahjwani, Dhwani" uniqKey="Sahjwani D" first="Dhwani" last="Sahjwani">Dhwani Sahjwani</name><affiliation wicri:level="2"><nlm:affiliation>Department of Pediatrics, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pediatrics, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Brown, A Whitney" sort="Brown, A Whitney" uniqKey="Brown A" first="A Whitney" last="Brown">A Whitney Brown</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Feroz, Saad" sort="Feroz, Saad" uniqKey="Feroz S" first="Saad" last="Feroz">Saad Feroz</name><affiliation wicri:level="2"><nlm:affiliation>Department of Pediatrics, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pediatrics, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Cameron, Paula" sort="Cameron, Paula" uniqKey="Cameron P" first="Paula" last="Cameron">Paula Cameron</name><affiliation wicri:level="2"><nlm:affiliation>Respiratory Therapy Department, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Respiratory Therapy Department, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Osborn, Erik" sort="Osborn, Erik" uniqKey="Osborn E" first="Erik" last="Osborn">Erik Osborn</name><affiliation wicri:level="2"><nlm:affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Desai, Mehul" sort="Desai, Mehul" uniqKey="Desai M" first="Mehul" last="Desai">Mehul Desai</name><affiliation wicri:level="2"><nlm:affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Djurkovic, Svetolik" sort="Djurkovic, Svetolik" uniqKey="Djurkovic S" first="Svetolik" last="Djurkovic">Svetolik Djurkovic</name><affiliation wicri:level="2"><nlm:affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Kasarabada, Aditya" sort="Kasarabada, Aditya" uniqKey="Kasarabada A" first="Aditya" last="Kasarabada">Aditya Kasarabada</name><affiliation wicri:level="2"><nlm:affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Hinerman, Rachel" sort="Hinerman, Rachel" uniqKey="Hinerman R" first="Rachel" last="Hinerman">Rachel Hinerman</name><affiliation wicri:level="2"><nlm:affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Lantry, James" sort="Lantry, James" uniqKey="Lantry J" first="James" last="Lantry">James Lantry</name><affiliation wicri:level="2"><nlm:affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Shlobin, Oksana A" sort="Shlobin, Oksana A" uniqKey="Shlobin O" first="Oksana A" last="Shlobin">Oksana A. Shlobin</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Ahmad, Kareem" sort="Ahmad, Kareem" uniqKey="Ahmad K" first="Kareem" last="Ahmad">Kareem Ahmad</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Khangoora, Vikramjit" sort="Khangoora, Vikramjit" uniqKey="Khangoora V" first="Vikramjit" last="Khangoora">Vikramjit Khangoora</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Aryal, Shambhu" sort="Aryal, Shambhu" uniqKey="Aryal S" first="Shambhu" last="Aryal">Shambhu Aryal</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Collins, A Claire" sort="Collins, A Claire" uniqKey="Collins A" first="A Claire" last="Collins">A Claire Collins</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease Research, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease Research, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Speir, Alan" sort="Speir, Alan" uniqKey="Speir A" first="Alan" last="Speir">Alan Speir</name><affiliation wicri:level="2"><nlm:affiliation>Department of Cardiothoracic Surgery, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Cardiothoracic Surgery, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Nathan, Steven" sort="Nathan, Steven" uniqKey="Nathan S" first="Steven" last="Nathan">Steven Nathan</name><affiliation wicri:level="2"><nlm:affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author></analytic><series><title level="j">PloS one</title><idno type="eISSN">1932-6203</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>PURPOSE</b></p><p>The outcomes of patients requiring invasive mechanical ventilation for COVID-19 remain poorly defined. We sought to determine clinical characteristics and outcomes of patients with COVID-19 managed with invasive mechanical ventilation in an appropriately resourced US health care system.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Outcomes of COVID-19 infected patients requiring mechanical ventilation treated within the Inova Health System between March 5, 2020 and April 26, 2020 were evaluated through an electronic medical record review.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>1023 COVID-19 positive patients were admitted to the Inova Health System during the study period. Of these, 164 (16.0%) were managed with invasive mechanical ventilation. All patients were followed to definitive disposition. 70/164 patients (42.7%) had died and 94/164 (57.3%) were still alive. Deceased patients were older (median age of 66 vs. 55, p <0.0001) and had a higher initial d-dimer (2.22 vs. 1.31, p = 0.005) and peak ferritin levels (2998 vs. 2077, p = 0.016) compared to survivors. 84.3% of patients over 70 years old died in the hospital. Conversely, 67.4% of patients age 70 or younger survived to hospital discharge. Younger age, non-Caucasian race and treatment at a tertiary care center were all associated with survivor status.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Mortality of patients with COVID-19 requiring invasive mechanical ventilation is high, with particularly daunting mortality seen in patients of advanced age, even in a well-resourced health care system. A substantial proportion of patients requiring invasive mechanical ventilation were not of advanced age, and this group had a reasonable chance for recovery.</p></div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">33227024</PMID><DateRevised><Year>2020</Year><Month>12</Month><Day>07</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">1932-6203</ISSN><JournalIssue CitedMedium="Internet"><Volume>15</Volume><Issue>11</Issue><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>PloS one</Title><ISOAbbreviation>PLoS One</ISOAbbreviation></Journal><ArticleTitle>Outcomes of mechanically ventilated patients with COVID-19 associated respiratory failure.</ArticleTitle><Pagination><MedlinePgn>e0242651</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1371/journal.pone.0242651</ELocationID><Abstract><AbstractText Label="PURPOSE">The outcomes of patients requiring invasive mechanical ventilation for COVID-19 remain poorly defined. We sought to determine clinical characteristics and outcomes of patients with COVID-19 managed with invasive mechanical ventilation in an appropriately resourced US health care system.</AbstractText><AbstractText Label="METHODS">Outcomes of COVID-19 infected patients requiring mechanical ventilation treated within the Inova Health System between March 5, 2020 and April 26, 2020 were evaluated through an electronic medical record review.</AbstractText><AbstractText Label="RESULTS">1023 COVID-19 positive patients were admitted to the Inova Health System during the study period. Of these, 164 (16.0%) were managed with invasive mechanical ventilation. All patients were followed to definitive disposition. 70/164 patients (42.7%) had died and 94/164 (57.3%) were still alive. Deceased patients were older (median age of 66 vs. 55, p <0.0001) and had a higher initial d-dimer (2.22 vs. 1.31, p = 0.005) and peak ferritin levels (2998 vs. 2077, p = 0.016) compared to survivors. 84.3% of patients over 70 years old died in the hospital. Conversely, 67.4% of patients age 70 or younger survived to hospital discharge. Younger age, non-Caucasian race and treatment at a tertiary care center were all associated with survivor status.</AbstractText><AbstractText Label="CONCLUSION">Mortality of patients with COVID-19 requiring invasive mechanical ventilation is high, with particularly daunting mortality seen in patients of advanced age, even in a well-resourced health care system. A substantial proportion of patients requiring invasive mechanical ventilation were not of advanced age, and this group had a reasonable chance for recovery.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>King</LastName><ForeName>Christopher S</ForeName><Initials>CS</Initials><Identifier Source="ORCID">0000-0003-3101-319X</Identifier><AffiliationInfo><Affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sahjwani</LastName><ForeName>Dhwani</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brown</LastName><ForeName>A Whitney</ForeName><Initials>AW</Initials><AffiliationInfo><Affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Feroz</LastName><ForeName>Saad</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cameron</LastName><ForeName>Paula</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Respiratory Therapy Department, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Osborn</LastName><ForeName>Erik</ForeName><Initials>E</Initials><Identifier Source="ORCID">0000-0003-4306-8905</Identifier><AffiliationInfo><Affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Desai</LastName><ForeName>Mehul</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Djurkovic</LastName><ForeName>Svetolik</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kasarabada</LastName><ForeName>Aditya</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hinerman</LastName><ForeName>Rachel</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lantry</LastName><ForeName>James</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Medical Critical Care Service, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shlobin</LastName><ForeName>Oksana A</ForeName><Initials>OA</Initials><AffiliationInfo><Affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ahmad</LastName><ForeName>Kareem</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Khangoora</LastName><ForeName>Vikramjit</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aryal</LastName><ForeName>Shambhu</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Collins</LastName><ForeName>A Claire</ForeName><Initials>AC</Initials><Identifier Source="ORCID">0000-0003-0503-3429</Identifier><AffiliationInfo><Affiliation>Advanced Lung Disease Research, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Speir</LastName><ForeName>Alan</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Cardiothoracic Surgery, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nathan</LastName><ForeName>Steven</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, United States of America.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>11</Month><Day>23</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>PLoS One</MedlineTA><NlmUniqueID>101285081</NlmUniqueID><ISSNLinking>1932-6203</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CoiStatement>The authors have declared that no competing interests exist.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>07</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>11</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>11</Month><Day>23</Day><Hour>17</Hour><Minute>10</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>11</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>11</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33227024</ArticleId><ArticleId IdType="doi">10.1371/journal.pone.0242651</ArticleId><ArticleId IdType="pii">PONE-D-20-21719</ArticleId><ArticleId IdType="pmc">PMC7682899</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Crit Care Resusc. 2020 Apr 06;22(2):119-125</Citation><ArticleIdList><ArticleId IdType="pubmed">32248675</ArticleId></ArticleIdList></Reference><Reference><Citation>JAMA. 2020 Apr 28;323(16):1574-1581</Citation><ArticleIdList><ArticleId IdType="pubmed">32250385</ArticleId></ArticleIdList></Reference><Reference><Citation>JAMA. 2003 Jun 11;289(22):2983-91</Citation><ArticleIdList><ArticleId IdType="pubmed">12799407</ArticleId></ArticleIdList></Reference><Reference><Citation>N Engl J Med. 2020 May 21;382(21):2012-2022</Citation><ArticleIdList><ArticleId IdType="pubmed">32227758</ArticleId></ArticleIdList></Reference><Reference><Citation>JAMA. 2020 May 26;323(20):2052-2059</Citation><ArticleIdList><ArticleId IdType="pubmed">32320003</ArticleId></ArticleIdList></Reference><Reference><Citation>Lancet. 2020 Mar 28;395(10229):1054-1062</Citation><ArticleIdList><ArticleId IdType="pubmed">32171076</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Virginie</li></region></list><tree><country name="États-Unis"><region name="Virginie"><name sortKey="King, Christopher S" sort="King, Christopher S" uniqKey="King C" first="Christopher S" last="King">Christopher S. King</name></region><name sortKey="Ahmad, Kareem" sort="Ahmad, Kareem" uniqKey="Ahmad K" first="Kareem" last="Ahmad">Kareem Ahmad</name><name sortKey="Aryal, Shambhu" sort="Aryal, Shambhu" uniqKey="Aryal S" first="Shambhu" last="Aryal">Shambhu Aryal</name><name sortKey="Brown, A Whitney" sort="Brown, A Whitney" uniqKey="Brown A" first="A Whitney" last="Brown">A Whitney Brown</name><name sortKey="Cameron, Paula" sort="Cameron, Paula" uniqKey="Cameron P" first="Paula" last="Cameron">Paula Cameron</name><name sortKey="Collins, A Claire" sort="Collins, A Claire" uniqKey="Collins A" first="A Claire" last="Collins">A Claire Collins</name><name sortKey="Desai, Mehul" sort="Desai, Mehul" uniqKey="Desai M" first="Mehul" last="Desai">Mehul Desai</name><name sortKey="Djurkovic, Svetolik" sort="Djurkovic, Svetolik" uniqKey="Djurkovic S" first="Svetolik" last="Djurkovic">Svetolik Djurkovic</name><name sortKey="Feroz, Saad" sort="Feroz, Saad" uniqKey="Feroz S" first="Saad" last="Feroz">Saad Feroz</name><name sortKey="Hinerman, Rachel" sort="Hinerman, Rachel" uniqKey="Hinerman R" first="Rachel" last="Hinerman">Rachel Hinerman</name><name sortKey="Kasarabada, Aditya" sort="Kasarabada, Aditya" uniqKey="Kasarabada A" first="Aditya" last="Kasarabada">Aditya Kasarabada</name><name sortKey="Khangoora, Vikramjit" sort="Khangoora, Vikramjit" uniqKey="Khangoora V" first="Vikramjit" last="Khangoora">Vikramjit Khangoora</name><name sortKey="Lantry, James" sort="Lantry, James" uniqKey="Lantry J" first="James" last="Lantry">James Lantry</name><name sortKey="Nathan, Steven" sort="Nathan, Steven" uniqKey="Nathan S" first="Steven" last="Nathan">Steven Nathan</name><name sortKey="Osborn, Erik" sort="Osborn, Erik" uniqKey="Osborn E" first="Erik" last="Osborn">Erik Osborn</name><name sortKey="Sahjwani, Dhwani" sort="Sahjwani, Dhwani" uniqKey="Sahjwani D" first="Dhwani" last="Sahjwani">Dhwani Sahjwani</name><name sortKey="Shlobin, Oksana A" sort="Shlobin, Oksana A" uniqKey="Shlobin O" first="Oksana A" last="Shlobin">Oksana A. Shlobin</name><name sortKey="Speir, Alan" sort="Speir, Alan" uniqKey="Speir A" first="Alan" last="Speir">Alan Speir</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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