This case series describes the clinical characteristics, treatment and outcomes of patients with laboratory confirmed COVID-19 admitted to a 35 beds intensive care unit of a tertiary hospital in Northeast Brazil.
This retrospective observational study will be carried out at Hospital São Domingos, state of
Maranhao, Brasil. It is a tertiary hospital with 450 beds and six Intensive Care Units (ICU)
with a total of 63 beds. With the admission of the first patients with Coronavirus Disease
2019 (COVID-19) as of March 20, we initially made available a 12 beds ICU exclusively for the
treatment of patients with COVID-19. At the beginning of April, the number of beds was
increased to 35 and, immediately afterwards, two semi-intensive units (16 and 21 beds) were
created for patients in need of non-invasive respiratory support, with the 35 beds ICU 35
dedicated to receive only patients in need of high-level support (usually invasive mechanical
ventilation) with or without other organ dysfunctions.
In the period from March 20 to June 15, 2020, 935 patients with confirmed diagnosis (RT-PCR)
of COVID-19 were admitted to the hospital and 187 of them were treated in the ICU.
Data were obtained from the hospital's electronic medical record. Demographic and severity
data included age, sex, Simplified Acute Physiology 3 (SAPS 3) and Sequential Organ Failure
Assessment (SOFA) scores at admission, nutritional risk determined by Nutritional Risk
Screening 2002 (NRS-2002) and commodities. Clinical and laboratory data on arrival at the ICU
including Partial pressure of oxygen in arterial bood / Inspired fraction of oxygen (PaO2 /
FIO2) complete blood count and PCR D-dimer, ferritin, fibrinogen and lactic acid
dehydrogenasew (LDH). Drug interventions including use of hydroxychloroquine,
corticosteroids, heparin, tocilizumab. Characteristics of invasive and non-invasive
respiratory support, use of prone position, ECMO and vasoactive drugs. The main
complications, acute kidney injury requiring hemodialysis, secondary infectious complications
will be documented as well as the outcomes.
Other: demographic and clinical data obtained from hospital's electronic medical record.
This retrospective observational study. . Demographic and severity data will include age, sex, SAPS 3 and SOFA scores at admission, nutritional risk determined by NRS-2002 and commodities. Clinical and laboratory data on arrival at the ICU including PaO2 / FIO2, blood count and PCR D-dimer, ferritin, fibrinogen, DHL. Drug interventions including use of hydroxychloroquine, corticosteroids, heparin, tocilizumab. Characteristics of invasive and non-invasive respiratory support, use of prone position and ECMO and vasoactive drugs. The main complications, acute kidney injury requiring renal replacement therapy, secondary infectious complications will be documented as well as the outcomes.
Inclusion Criteria:
- All patients admitted to the 35 beds ICU between March 20 and June 15, 2020 with
laboratory confirmed diagnosis of COVID-19 (RT-PCR).
Exclusion Criteria:
- Patients admitted to the ICU in which the RT-PCR was negative, and patients that did
not require high level life support (RRT, Prone position, ECMO, hemodymnamic
monitoring and support).
Hospital Sao Domingos
Sao Luis, MA, Brazil
JOSE AZEVEDO, MD, Study Chair
Hospital Sao Domingos