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08 april 2020

Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy - JAMA

6-4-2020; doi:10.1001/jama.2020.5394 
By: G. Grasselli, et al. 

Describe clinical characteristics of COVID-19 patients admitted to the ICUs of Lombardy.


  • Clinical characteristics of 1591 ICU-patients in Lombardy are described
  • 99% required respiratory support, 88% intubation and mechanical ventilation and 11% non-invasive ventilation. 
  • ICU mortality was 26% while 58% of patients was still admitted to the ICU at study closure.


  • All COVID-19 patients (= positive RT-PCR of nasal and pharyngeal swabs) admitted to the ICU’s of 72 Lombardy between 20-2 and 18-3 were included. 
  • 1591 inclusions, 82% male, median age 63, 23% was 71 years or older, 13% was younger than 50.
  • Hypertension most common comorbidity (49%). Cardiovascular disease and hypercholesterolemia were second and third most common.
  • 99% of ICU admitted patients required (non)-invasive respiratory support, 88% were intubated and mechanically ventilated. Median PEEP was 14 cm H20. 89% required FiO2 of at least 50%. 12% required 100%. 27% required prone ventilation en 1% ECMO at admission
  • Hypertensive patients had higher ventilation requirements
  • 58% of patients were still at ICU when the study closed, 16% were discharged from ICU and 26% had died (underestimation since 58% of patients was still on ICU at study closure). Mortality rates were higher among elderly and hypertensive patients.
  • Median ICU length of stay was 8 days for discharged patients. And 10 days for patients still admitted (underestimation).
  • Mechanical ventilation rates in this study is much higher compared to other literature which is probably due to non-invasively ventilated patients being treated on wards in Italy and therefore not requiring ICU admittance (and exclusion of the current study).
  • 63 is also the median age of all infected Italian patients indicating older age is not a risk factor for ICU admittance.