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Outcomes of patients with COVID-19 Acute Respiratory Distress Syndrome requiring Invasive Mechanical Ventilation admitted to an Intensive Care Unit in South Africa
Background Up to 30% of patients with COVID-19 pneumonia may require ICU admission or mechanical ventilation [Guan et al., 2020; Huang et al., 2020]. Data from low- and middle-income countries for COVID-19 ARDS are limited. Groote Schuur Hospital in Cape Town, South Africa expanded its ICU service t...
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| Format: | Thesis |
| Language: | English |
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Department of Anaesthesia and Perioperative Medicine
2023
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| _version_ | 1867613201879793664 |
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| access_status_str | Open Access |
| author | Arnold-Day, Christel |
| author2 | Piercy, Jenna |
| author_browse | Arnold-Day, Christel Piercy, Jenna |
| author_facet | Piercy, Jenna Arnold-Day, Christel |
| author_sort | Arnold-Day, Christel |
| collection | Thesis |
| description | Background Up to 30% of patients with COVID-19 pneumonia may require ICU admission or mechanical ventilation [Guan et al., 2020; Huang et al., 2020]. Data from low- and middle-income countries for COVID-19 ARDS are limited. Groote Schuur Hospital in Cape Town, South Africa expanded its ICU service to support patients with COVID-19 ARDS requiring invasive mechanical ventilation (IMV). We report on patients' characteristics and outcomes from two pandemic waves. Methods All patients with COVID-19 ARDS admitted to the ICU for IMV were included in this prospective cohort study. Data were collected from 5th April 2020 to 5th April 2021. Ethical approval was granted (HREC: 362/2020), consent was waived for deceased patients and deferred for survivors. Results Over the 12-month study period 461 patients were admitted to the designated COVID-19 ICU. Of these, 380 patients met study criteria and 377 had confirmed hospital discharge outcomes. The median age of patients was 51 years (range 17-71), 50.5% were female and the median BMI was 32kg/m2 (IQR 28-38). The median P/F ratio was 97 (IQR 71.5-127.5) after IMV was initiated. Comorbidities included diabetes (47.6%), hypertension (46.3%) and HIV infection (10%). Of the patients admitted, 30.8% survived to hospital discharge with a median ICU length of stay of 19.5 days (IQR 9- 36). Predictors of mortality after adjusting for confounders were: male (OR:1.79), increasing age (OR:1.04) and SOFA score (OR:1.29). Conclusion In a resource limited environment, escalation of ICU IMV support achieved a 30.8% hospital survival in patients with COVID-19 ARDS. The ability to predict survival remains difficult given this complex disease. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/37426 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:21.936Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Department of Anaesthesia and Perioperative Medicine |
| publisherStr | Department of Anaesthesia and Perioperative Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/37426 Outcomes of patients with COVID-19 Acute Respiratory Distress Syndrome requiring Invasive Mechanical Ventilation admitted to an Intensive Care Unit in South Africa Arnold-Day, Christel Piercy, Jenna Van Zyl-Smit, Richard Acute respiratory distress syndrome COVID-19, SARS-COV-2 critically ill invasive mechanical ventilation South Africa Africa hospital mortality outcomes low- and middle-income countries Background Up to 30% of patients with COVID-19 pneumonia may require ICU admission or mechanical ventilation [Guan et al., 2020; Huang et al., 2020]. Data from low- and middle-income countries for COVID-19 ARDS are limited. Groote Schuur Hospital in Cape Town, South Africa expanded its ICU service to support patients with COVID-19 ARDS requiring invasive mechanical ventilation (IMV). We report on patients' characteristics and outcomes from two pandemic waves. Methods All patients with COVID-19 ARDS admitted to the ICU for IMV were included in this prospective cohort study. Data were collected from 5th April 2020 to 5th April 2021. Ethical approval was granted (HREC: 362/2020), consent was waived for deceased patients and deferred for survivors. Results Over the 12-month study period 461 patients were admitted to the designated COVID-19 ICU. Of these, 380 patients met study criteria and 377 had confirmed hospital discharge outcomes. The median age of patients was 51 years (range 17-71), 50.5% were female and the median BMI was 32kg/m2 (IQR 28-38). The median P/F ratio was 97 (IQR 71.5-127.5) after IMV was initiated. Comorbidities included diabetes (47.6%), hypertension (46.3%) and HIV infection (10%). Of the patients admitted, 30.8% survived to hospital discharge with a median ICU length of stay of 19.5 days (IQR 9- 36). Predictors of mortality after adjusting for confounders were: male (OR:1.79), increasing age (OR:1.04) and SOFA score (OR:1.29). Conclusion In a resource limited environment, escalation of ICU IMV support achieved a 30.8% hospital survival in patients with COVID-19 ARDS. The ability to predict survival remains difficult given this complex disease. 2023-03-13T14:19:05Z 2023-03-13T14:19:05Z 2022 2023-02-20T12:13:07Z Master Thesis Masters MPhil http://hdl.handle.net/11427/37426 eng application/pdf Department of Anaesthesia and Perioperative Medicine Faculty of Health Sciences |
| spellingShingle | Acute respiratory distress syndrome COVID-19, SARS-COV-2 critically ill invasive mechanical ventilation South Africa Africa hospital mortality outcomes low- and middle-income countries Arnold-Day, Christel Outcomes of patients with COVID-19 Acute Respiratory Distress Syndrome requiring Invasive Mechanical Ventilation admitted to an Intensive Care Unit in South Africa |
| thesis_degree_str | Master's |
| title | Outcomes of patients with COVID-19 Acute Respiratory Distress Syndrome requiring Invasive Mechanical Ventilation admitted to an Intensive Care Unit in South Africa |
| title_full | Outcomes of patients with COVID-19 Acute Respiratory Distress Syndrome requiring Invasive Mechanical Ventilation admitted to an Intensive Care Unit in South Africa |
| title_fullStr | Outcomes of patients with COVID-19 Acute Respiratory Distress Syndrome requiring Invasive Mechanical Ventilation admitted to an Intensive Care Unit in South Africa |
| title_full_unstemmed | Outcomes of patients with COVID-19 Acute Respiratory Distress Syndrome requiring Invasive Mechanical Ventilation admitted to an Intensive Care Unit in South Africa |
| title_short | Outcomes of patients with COVID-19 Acute Respiratory Distress Syndrome requiring Invasive Mechanical Ventilation admitted to an Intensive Care Unit in South Africa |
| title_sort | outcomes of patients with covid 19 acute respiratory distress syndrome requiring invasive mechanical ventilation admitted to an intensive care unit in south africa |
| topic | Acute respiratory distress syndrome COVID-19, SARS-COV-2 critically ill invasive mechanical ventilation South Africa Africa hospital mortality outcomes low- and middle-income countries |
| url | http://hdl.handle.net/11427/37426 |
| work_keys_str_mv | AT arnolddaychristel outcomesofpatientswithcovid19acuterespiratorydistresssyndromerequiringinvasivemechanicalventilationadmittedtoanintensivecareunitinsouthafrica |