Factors Associated with 90-Day Mortality in Invasively Ventilated Patients with COVID-19 in Marseille, France

Maxime Volff , David Tonon , Youri Bommel , Noémie Peres , David Lagier , Geoffray Agard , Alexis Jacquier (1, 2) , Axel Bartoli (1, 2) , Julien Carvelli , Howard Max , Pierre Simeone , Valery Blasco , Bruno Pastene , Anderson Loundou , Laurent Boyer , Marc Leone (3) , Lionel Velly , Jérémy Bourenne (4) , Salah Boussen (5) , Mickaël Bobot (6, 7, 8) , Nicolas Bruder (9)

1 Department of Radiology, Assistance Publique des Hôpitaux de Marseille
2 CRMBM - Centre de résonance magnétique biologique et médicale
3 MEPHI - Microbes évolution phylogénie et infections
4 TIMONE - Hôpital de la Timone [CHU - APHM]
5 Service d'anesthésie et de réanimation [Hôpital de la Timone - APHM]
6 Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM]
7 CERIMED - Centre Européen de Recherche en Imagerie médicale
8 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
9 APHM - Assistance Publique - Hôpitaux de Marseille

OBJECTIVES: To describe clinical characteristics and management of intensive care units (ICU) patients with laboratory-confirmed COVID-19 and to determine 90-day mortality after ICU admission and associated risk factors. METHODS: This observational retrospective study was conducted in six intensive care units (ICUs) in three university hospitals in Marseille, France. Between 10 March and 10 May 2020, all adult patients admitted in ICU with laboratory-confirmed SARS-CoV-2 and respiratory failure were eligible for inclusion. The statistical analysis was focused on the mechanically ventilated patients. The primary outcome was the 90-day mortality after ICU admission. RESULTS: Included in the study were 172 patients with COVID-19 related respiratory failure, 117 of whom (67%) received invasive mechanical ventilation. 90-day mortality of the invasively ventilated patients was 27.4%. Median duration of ventilation and median length of stay in ICU for these patients were 20 (9-33) days and 29 (17-46) days. Mortality increased with the severity of ARDS at ICU admission. After multivariable analysis was carried out, risk factors associated with 90-day mortality were age, elevated Charlson comorbidity index, chronic statins intake and occurrence of an arterial thrombosis. CONCLUSION: In this cohort, age and number of comorbidities were the main predictors of mortality in invasively ventilated patients. The only modifiable factor associated with mortality in multivariate analysis was arterial thrombosis.

Mots clés: acute respiratory distress syndrome; Covid-19; cvs; intensive care unit; mechanical ventilation; prognostic factors; SARS-CoV-2

Domaines: Imagerie; Imagerie médicale; Cardiologie et système cardiovasculaire

Maxime Volff, David Tonon, Youri Bommel, Noémie Peres, David Lagier, et al.. Factors Associated with 90-Day Mortality in Invasively Ventilated Patients with COVID-19 in Marseille, France. Journal of Clinical Medicine, 2021, 10 (23), pp.5650. ⟨10.3390/jcm10235650⟩. ⟨hal-03591711⟩