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Severe COVID‐19 pneumonia in an intensive care setting and comparisons with historic severe viral pneumonia due to other viruses

Severe COVID‐19 pneumonia in an intensive care setting and comparisons with historic severe viral pneumonia due to other viruses
Severe COVID‐19 pneumonia in an intensive care setting and comparisons with historic severe viral pneumonia due to other viruses

Purpose: Severe viral pneumonia is associated with significant morbidity and mortality. Recent COVID-19 pandemic continues to impose significant health burden worldwide, and individual pandemic waves often lead to a large surge in the intensive care unit (ICU) admissions for respiratory support. Comparisons of severe SARS-CoV-2 pneumonia with other seasonal and nonseasonal severe viral infections are rarely studied in an intensive care setting. Methods: A retrospective cohort study comparing patients admitted to ICU with COVID-19 between March and June 2020 and those with viral pneumonias between January and December 2019. We compared patient specific demographic variables, duration of illness, ICU organ supportive measures and outcomes between both groups. Results: Analysis of 93 COVID-19 (Group 1) and 52 other viral pneumonia patients (Group 2) showed an increased proportion of obesity (42% vs. 23%, p = 0.02), non-White ethnicities (41% vs. 6%, p < 0.001) and diabetes mellitus (30% vs. 13%, p = 0.03) in Group 1, with lower prevalence of chronic obstructive pulmonary disease (COPD)/asthma (16% vs. 34%, p = 0.02). In Group 1, the neutrophil to lymphocyte ratio was much lower (6.7 vs. 10, p = 0.006), and invasive mechanical ventilation (58% vs. 26%, p < 0.001) was more common. Length of ICU (8 vs. 4, p < 0.001) and hospital stay (22 vs. 11, p < 0.001) was prolonged in Group 1, with no significant difference in mortality. Influenza A and rhinovirus were the most common pathogens in Group 2 (26% each). Conclusions: Key differences were identified within demographics (obesity, ethnicity, age, ICU scores, comorbidities) and organ support. Despite these variations, there were no significant differences in mortality between both groups. Further studies with larger sample sizes would allow for further assessment of clinical parameters in these patients.

COVID-19, intensive care, viral pneumonia
301-308
Dadhwal, Kiran
f279714d-08ba-4c43-a170-fb63464bc8df
Stonham, Rosalind
b81521f5-5e81-4df8-9b68-81e1cf0bce91
Breen, Hannah
4ce96bec-bb3b-45a1-abfc-7d9e4e8b1d67
Poole, Stephen
440d7904-ab72-469c-892b-c910cd1cb19b
Saeed, Kordo
87cb67e5-71e8-4759-bf23-2ea00ebd8b39
Dushianthan, Ahilanandan
013692a2-cf26-4278-80bd-9d8fcdb17751
Dadhwal, Kiran
f279714d-08ba-4c43-a170-fb63464bc8df
Stonham, Rosalind
b81521f5-5e81-4df8-9b68-81e1cf0bce91
Breen, Hannah
4ce96bec-bb3b-45a1-abfc-7d9e4e8b1d67
Poole, Stephen
440d7904-ab72-469c-892b-c910cd1cb19b
Saeed, Kordo
87cb67e5-71e8-4759-bf23-2ea00ebd8b39
Dushianthan, Ahilanandan
013692a2-cf26-4278-80bd-9d8fcdb17751

Dadhwal, Kiran, Stonham, Rosalind, Breen, Hannah, Poole, Stephen, Saeed, Kordo and Dushianthan, Ahilanandan (2022) Severe COVID‐19 pneumonia in an intensive care setting and comparisons with historic severe viral pneumonia due to other viruses. The Clinical Respiratory Journal, 16 (4), 301-308. (doi:10.21203/rs.3.rs-583767/v1).

Record type: Article

Abstract

Purpose: Severe viral pneumonia is associated with significant morbidity and mortality. Recent COVID-19 pandemic continues to impose significant health burden worldwide, and individual pandemic waves often lead to a large surge in the intensive care unit (ICU) admissions for respiratory support. Comparisons of severe SARS-CoV-2 pneumonia with other seasonal and nonseasonal severe viral infections are rarely studied in an intensive care setting. Methods: A retrospective cohort study comparing patients admitted to ICU with COVID-19 between March and June 2020 and those with viral pneumonias between January and December 2019. We compared patient specific demographic variables, duration of illness, ICU organ supportive measures and outcomes between both groups. Results: Analysis of 93 COVID-19 (Group 1) and 52 other viral pneumonia patients (Group 2) showed an increased proportion of obesity (42% vs. 23%, p = 0.02), non-White ethnicities (41% vs. 6%, p < 0.001) and diabetes mellitus (30% vs. 13%, p = 0.03) in Group 1, with lower prevalence of chronic obstructive pulmonary disease (COPD)/asthma (16% vs. 34%, p = 0.02). In Group 1, the neutrophil to lymphocyte ratio was much lower (6.7 vs. 10, p = 0.006), and invasive mechanical ventilation (58% vs. 26%, p < 0.001) was more common. Length of ICU (8 vs. 4, p < 0.001) and hospital stay (22 vs. 11, p < 0.001) was prolonged in Group 1, with no significant difference in mortality. Influenza A and rhinovirus were the most common pathogens in Group 2 (26% each). Conclusions: Key differences were identified within demographics (obesity, ethnicity, age, ICU scores, comorbidities) and organ support. Despite these variations, there were no significant differences in mortality between both groups. Further studies with larger sample sizes would allow for further assessment of clinical parameters in these patients.

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Available under License Creative Commons Attribution.
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Accepted/In Press date: 27 January 2022
e-pub ahead of print date: 24 February 2022
Published date: 24 February 2022
Additional Information: Funding Information: We thank Stephen Aplin, surveillance officer in the Infection Prevention Team at University Hospital Southampton, for his support in getting some of the data for this work. This work was performed in authors own time, and no additional funding was obtained for the work. Publisher Copyright: © 2022 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd.
Keywords: COVID-19, intensive care, viral pneumonia

Identifiers

Local EPrints ID: 454585
URI: http://eprints.soton.ac.uk/id/eprint/454585
PURE UUID: cee4de46-a5c4-4773-a63a-6e66ca367e08
ORCID for Kordo Saeed: ORCID iD orcid.org/0000-0003-0123-0302
ORCID for Ahilanandan Dushianthan: ORCID iD orcid.org/0000-0002-0165-3359

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Date deposited: 16 Feb 2022 17:45
Last modified: 01 Feb 2023 02:55

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Contributors

Author: Kiran Dadhwal
Author: Rosalind Stonham
Author: Hannah Breen
Author: Stephen Poole
Author: Kordo Saeed ORCID iD
Author: Ahilanandan Dushianthan ORCID iD

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