Original Article

Risk Factors for Mortality in Mechanically Ventilated Patients with COVID-19 in a Mississippi Community Health System

Authors: S. Ijlal Babar, MD, Ashley E. Hawthorne, PharmD, BCCCP, Maggie R. Clarkson, RN, MSN


Objective: To evaluate differences between survivors versus nonsurvivors undergoing mechanical ventilation for coronavirus disease 2019 (COVID-19)–associated respiratory failure at two community medical centers.

Methods: This was a multicenter, retrospective cohort analysis of all adult patients mechanically ventilated for COVID-19–associated respiratory failure in two community hospital intensive care units in southern Mississippi from March 15, 2020 through October 10, 2020.

Results: Among 56 patients requiring mechanical ventilation, the mortality rate was 75% (42/56). Expired patients were intubated later (2 vs 5 days, 95% confidence interval [CI] 6.314–0.8041, P = 0.0983), had lower PaO2:FiO2 ratios (65 vs 77.5 mm Hg, 95% CI 36.08–59.03, P = 0.6305), and tolerated lower levels of positive end-expiratory pressure (7.9 vs 12.6 cm H2O, 95% CI 0.1373–6.722, P = 0.0415) at the time of intubation.

Conclusions: Our results suggest that earlier intubation may be associated with reduced mortality in patients with COVID-19-associated respiratory failure and should be further evaluated in the form of a randomized controlled trial.
Posted in: Infectious Disease84

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Table 1. Demographic characteristics and comorbidities by survival status (N = 56) March 15–October 10, 2020

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Table 2. Patient parameters by survival status (N = 56), March 15–October 10, 2020

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1. Lim ZJ, Subramaniam A, Reddy MP, et al. Case fatality rates for patients with COVID-19 requiring invasive mechanical ventilation. Am J Respir Crit Care Med 2021;203:54–66.
2. Babar I, Ekenna O, Clarkson M, et al. COVID-19 in a Mississippi community hospital. South Med J 2021;114:305–310.
3. Pandya A, Kaur NA, Sacher D, et al. Ventilatory mechanics in early vs late intubation in a cohort of coronavirus disease 2019 patients with ARDS: a single center’s experience. Chest 2021;159:653–656.
4. Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy. JAMA 2020;323:1574–1581.
5. Luo M, Cao S, Wei L, et al. Intubation, mortality, and risk factors in critically ill COVID-19 patients: a pilot study. J Clin Anesth 2020;67:10039.
6. Marini JJ, Gattinoni L. Management of COVID-19 respiratory distress. JAMA 2020;323:2329–2330.
7. Amato M, Meade M, Slutsky A, et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 2015;372:747–755.