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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Intensive care unit hospitalizations and outcomes in patients with severe COVID-19 during summer and fall surges in Georgia
Titilope Olanipekun, Temidayo Ayotomiwa Abe, Valery Sammah Effoe, Joffi E Musonge-Effoe, Agusiegbe Chuks, Esther Kwara, Alexandra Caldwell, Samed Obeng, Nicolas Bakinde, Gloria Westney, Richard Snyder
Titilope Olanipekun, Department of Hospital Medicine, Covenant Health System, Knoxville, TN, Covenant Health System, Knoxville, TX 37922, United States
Temidayo Ayotomiwa Abe, Agusiegbe Chuks, Esther Kwara, Alexandra Caldwell, Samed Obeng, Nicolas Bakinde, Richard Snyder, Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310, United States
Valery Sammah Effoe, Department of Cardiology, Morehouse School of Medicine, Atlanta, GA 30310, United States
Joffi E Musonge-Effoe, Department of Clinical Research, Morehouse School of Medicine, Atlanta, GA 30310, United States
Gloria Westney, Department of Medicine, Pulmonary and Critical Care Section, Morehouse School of Medicine, Atlanta, GA 30310, United States
Author contributions: Olanipekun T and Abe T contributed to study conception and manuscript writing; Effoe VS, and Musonge-Effoe J contributed to study conception and critical review; Chuks A, Kwara E, Caldwell A and Obeng S, contributed to data extraction and critical review; Bakinde N, Westney G and Snyder R contributed to study conception and critical review; All authors have read and approved the final manuscript.
Institutional review board statement: Data from this study used de-identified data from the National Inpatient Sample Database. A publicly available all-payer inpatient care database in the United States. Institutional Review Board Approval Form or Document is not required.
Informed consent statement: Data from this study used de-identified data from the National Inpatient Sample Database. A publicly available all-payer inpatient care database in the United States. Informed patient consent is not required.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Titilope Olanipekun, MD, Academic Research, Department of Hospital Medicine, Covenant Health System, Knoxville, TN, Covenant Health System, 100 Fort Sanders W Blvd, Knoxville100 Fort Sanders W Blvd, Knoxville, Knoxville, TX 37922, United States. toolanipekun@gmail.com
Received: June 24, 2021
Peer-review started: June 24, 2021
First decision: July 27, 2021
Revised: August 5, 2021
Accepted: September 16, 2021
Article in press: September 16, 2021
Published online: November 9, 2021
Processing time: 133 Days and 15.7 Hours
BACKGROUND
There is limited data on the difference in the clinical characteristics and outcomes of patients with severe coronavirus disease 2019 (COVID-19) infection in the summer compared to the fall surge.
AIM
To compare the sociodemographic, clinical characteristics, and outcomes among mechanically ventilated patients with severe COVID-19 infection admitted to the intensive care unit (ICU) during the summer and fall surges in the year 2020.
METHODS
We included patients admitted to the ICU and treated with invasive mechanical ventilation for COVID-19 associated respiratory failure between April 1 and December 31, 2020. Patients were categorized into summer surge for ICU admissions between June 15, 2020, and August 15, 2020, and fall surge between October 15, 2020, and December 31, 2020. We compared patients' characteristics and outcomes using descriptive and inferential statistics.
RESULTS
A total of 220 patients were admitted to the Grady Memorial Hospital ICU and mechanically ventilated for COVID-19 associated hypoxemic respiratory failure during the period considered (125 during the summer surge and 95 during the fall surge). More women were admitted in the fall compared to summer (41.1% vs 36.8%, difference, 4.3%; 95%CI: 1.2, 7.5). Patients admitted in the fall had fewer comorbidities (chronic obstructive pulmonary disease, stroke, diabetes mellitus, obstructive sleep apnea and body mass index ≥ 35 kg/m2). Overall, patients in the fall had a lower ICU mortality rate (27.4% vs 38.4%, difference, -11.0; 95%CI: -6.4, -18.2), shorter length of stay on the mechanical ventilator (7 d vs 11 d, difference, 4 d; 95%CI: 2.1, 6.6) and shorter ICU length of stay (9 d vs 14 d, difference, 5 d; 95%CI: 2.7, 9.4).
CONCLUSION
Patients admitted with severe COVID-19 infection requiring mechanical ventilation had better outcomes in the fall than summer. This difference observed is likely attributable to a better understanding of the condition and advances in treatment strategies.
Core Tip: In this observational study, we compared the sociodemographic, clinical characteristics, and outcomes among mechanically ventilated patients with coronavirus disease 2019 (COVID-19) infection admitted to the intensive care unit (ICU) during the summer and fall surges in the year 2020. Compared to patients admitted with severe COVID-19 in the summer, those in the fall had better outcomes including decreased mortality and low length of stay in the ICU. This is likely due to the improved understanding of COVID-19 and the advances in treatment strategies.
