重症COVID–19肺炎の急性期の循環動態は比較的安定している～単施設・症例対照研究～(Critically ill patients with novel coronavirus infectious disease (COVID–19) are relatively hemodynamically stable in the acute phase: a single–centered, retrospective, observational study)

Abstract

ABSTRACT To clarify the clinical course of severe COVID–19 pneumonia requiring ventilator support, we investigated the difference of SOFA scores between severe COVID–19 pneumonia and severe pneumonia patients before the emergence of COVID–19. In this single–centered, retrospective, observational study, we enrolled 14 COVID–19 patients requiring ventilator management between February 2020 and May 2020 (COVID–19 group) and 14 patients with pneumonia requiring ventilator management between January 2017 to December 2018 (non–COVID–19 group). We investigated demographic data, laboratory values, treatment, and the SOFA scores on Day 0, 1, and 3, with Day 0 being the day of intubation. The mean age of the 14 COVID–19 patients was 68.3 years and there was no difference in comorbidities and in–hospital mortality with the two groups. The mean SOFA scores (COVID–19 vs. non–COVID–19 group) on the day of intubation were 3.0 vs. 3.1 for respiratory system, 0.1 vs. 2.8 for cardiovascular system, 0.5 vs. 0.6 for coagulation, 0.3 vs. 0.6 for hepatobiliary system, 0.8 vs. 1.6 for central nervous system, and 0.4 vs. 1.3 for renal system, respectively. Significant differences were recognized in cardiovascular system (p<0.01) and central nervous system (p=0.049). The SOFA subscores for cardiovascular system remained significantly lower in the COVID group on Day 1 and 3. The rate of patients who used any vasopressors and the median fluid volume on the day of intubation were significantly lower in COVID–19 group. In conclusion, the hemodynamics were seemed to be more stable in severe COVID–19 pneumonia compared to non–COVID–19 severe pneumonia.