Outcome of a cohort of critically ill patients with severeacute respiratory failure in COVID19 pneumonia. the Trentosub-intensive care unit (SICU) experience

Background and Aim: The COVID19 pandemic affected predominantly north Italian regions, including Trentino-Alto Adige Weaimed to investigate the outcomes of severe acute respiratory failure COVID 19 patients Materials and Methods: We performed a cohort study of SARSCoV2 infected patients consecutively admitted to the SICU at S Chiara Hospital, from March 21st to May 4th In-hospital cumulativemortality was calculated Results: 46 patients were included (male 76%;mean age 63, IQR,55-74) Of those 30 (65%) had comorbidities All but 5 were treatedwith CPAP (helmet 37/41, 90%) Overall, 16 (35%) were steppedup to the intensive care unit (ICU), of those 3 died Of the remaining,7 died in SICU Those who died were older (age 78, IQR 72-86), andwith comorbidities The overall mortality was 22% (10/46) Compared with patients treated with non-invasive ventilation (NIV), thoseadmitted to the ICU had a lower PaO2/FiO2 ratio (163 vs 208), anda lower benefit after a CPAP trial (delta PaO2/FiO2 +22 vs +46) No difference was found in the time between symptoms onset andhospital arrival (7 days, IQR 5-9, vs 7 days, IQR 4-9), as well as inbiochemical parameters The overall hospital length of stay was 39days (IQR 33-40) for those admitted to the ICU, and 19 days (IQR13-21) for those treated with NIV Conclusions: In our experience 1/3 of patients admitted to theSICU required invasive ventilation Delay from symptoms onset tohospital arrival did not correlate with step-up to ICU, whereasbaseline PaO2/FiO2 and its increased after a CPAP trial did Overall, 1 by 4 patients died