- COVID-19 is primarily infecting older patients with comorbid conditions such as diabetes and cardiac disease.
- Children so far have experienced milder symptoms.
- Pregnant women who have been infected have also had a milder effect.
- The median duration between onset of symptoms and admission to the ICU is around 9 to 10 days.
- Primary reasons for ICU admission have been respiratory support. Two-thirds of patients have met the criteria for ARDS.
- Rapid access to diagnostic testing continues to be a priority as it enables clinicians to take action and implement infection control practices.
- The principal feature of those suffering from serious disease from COVID-10 is the development of ARDS.
- Treatment strategies for such patients include conservative fluid strategies for patients without shock following initial resuscitation, early antibiotics if bacterial co-infection is suspected, lung-protective ventilation, prone positioning, and ECMO for refractory hypoxaemia.
- Septic shock and specific organ dysfunction are also being observed in a significant proportion of patients with COVID-19-related critical illness.
- A large majority of severely affected patients have received targeted therapies, including neuraminidase inhibitors and corticosteroids.
- Mortality among all infected patients remains between 0.5% to 4%, but among those who have to be hospitalised, mortality is around 5 to 15%. Mortality rates are between 22 to 62% among those who become critically ill.
- The exact cause of death remains unknown, but presumed reasons include progressive hypoxia and multiorgan dysfunction.
- Additional critical care strategies are also being implemented including admission of patients with suspected infection to private rooms, use of face masks during assessment and transfer, maintaining a distance of at least 2 m between patients, extra caution when using high-flow nasal oxygen or non-invasive ventilation, and additional airborne precautions including N95 respirators and eye protection.
- Critical care facilities are also ensuring their staff receives updated training in infection prevention and control, including the use of protective equipment.
#CoronavirusOutbreak: Caring for the Critically Ill - Trends, Treatment and Mortality
Published on : Mon, 16 Mar 2020
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