Figures
- FIGURE 1
A representative flow of patients with COVID-19 from the emergency department through the high-dependency unit to intensive care from an unspecified number of infected individuals. Data from Martinelli et al. [5], from 281 461 patients. Post-COVID-19 data not available. ED: emergency department; HDU: high-dependency unit; ICU: intensive care unit; PH: prehospital.
- FIGURE 2
COVID-19 representative computed tomography scans. a) Emergency department: Lung weight=1197.5 g; Gas volume=3937.6 mL; Fraction of non-aerated tissue=0.054; PaO2/FIO2 ratio=146. b) High-dependency unit: Lung weight=1088.6 g; Gas volume=1569.9 mL; Fraction of non-aerated tissue=0.168; PaO2/FIO2 ratio=210. c) Intensive care unit: Lung weight=1399.2 g; Gas volume=1257.5 mL; Fraction of non-aerated tissue=0.389; PaO2/FIO2 ratio=112. FIO2: inspiratory oxygen fraction; PaO2: arterial oxygen tension.
- FIGURE 3
Summary of COVID-19 pathophysiology time course of patients who fail to improve. Atelectasis/recruitability progressively increase during the disease course until a later phase, characterised by fibrosis development. These anatomical changes are associated with a progressive decrease of respiratory system compliance, same or higher ventilation and a decreased PaCO2. Note that oxygenation does not change remarkably during the disease course, although, the mechanisms of hypoxaemia are likely to shift from V′A/Q′ misdistribution to true shunt. ED: emergency department; HDU: high-dependency unit; ICU: intensive care unit; PaCO2: arterial carbon dioxide tension; V′A/Q′: ventilation/perfusion ratio.
Tables
- TABLE 1
Clinical presentation of COVID-19 pneumonia during the first (1 February 2020 to 31 May 2020) and second (1 June 2020 to 1 June 2021) waves
Variables First wave Second wave Wave References Age (years) 61±11.63 52±18.6 1° [6, 7, 9, 12, 14, 16, 17, 19–22] 2° [14, 15, 17, 19–22] Gender, male (%) 51 55 1° [6–9, 14–17, 19–22] 2° [14, 15, 17, 19–22] Symptoms] Cough (%) 47.2 40.8 1° [6, 8, 13, 14, 16, 19, 22] 2° [13, 14, 19, 22] Fever (%) 46.6 55 1° [6, 8, 14, 16, 19, 22] 2° [13, 14, 19, 21, 22] Dyspnoea (%) 31.7 33.5 1° [6, 8, 13, 14, 16, 19, 22] 2° [13, 14, 19, 22] Fatigue, asthenia (%) 18.2 27 1° [8, 16] 2° [22] Acute kidney injury (%) 10.8 17 1° [19] 2° [19] Diarrhoea (%) 6 5 1° [6, 8, 14, 16, 19] 2° [13, 14, 19, 22] Vomiting (%) 2.7 5 1° [14, 16, 19] 2° [14, 19] Neurological symptoms (%) 0.6 0.7 1° [14, 16] 2° [14] Gas exchange] PaO2 (mmHg) 69.7±21.36 65 (56–74) 1° [8, 15] 2° [15] PaCO2 (mmHg) 34.1±4.7 32 (28–84) 1° [10, 15] 2° [15] PaO2/FIO2 ratio (mmHg) 182±65.29 249±111 1° [7, 9, 10, 15] 2° [15] Respiratory rate (breaths per min) 23±4.8 28 (22–33) 1° [8, 10, 15] 2° [15] Saturation (%) 94±2.78 93 (89–97) 1° [8, 15, 18] 2° [15] Data expressed as mean±sd or median (interquartile range), unless otherwise stated. PaO2: arterial oxygen tension; PaCO2: arterial carbon dioxide tension; FIO2: inspiratory oxygen fraction.
- TABLE 2
Mechanical ventilation in COVID-19 pneumonia
Author Patients enrolled Early intubation n (%) Deceased n (%) Late intubation n (%) Deceased n (%) Zuccon [79] 54 25 (46.3) 9 (36) 23 (42.6) 12 (52.2) Lee [80] 47 23 (48.9) 13 (56.5) 16 (34.0) 7 (43.8) Karagiannidis [81] 10 021 1318 (13.2) 696 (52.8) 141 (1.4) 70 (49.6) Grasselli [82] 3988 2929 (73.4) 1514 (51.7) 151 (3.8) NA Matta [83] 111 76 (68.5) 54 (71.1) 35 (31.5) 20 (57.1) Hernandez-Romieu [84] 231 132 (57.1) 47 (35.6) 42 (18.2) 16 (38.1) Mellado-Artigas [85] 122 61 (50) 13 (21.3) 23 (18.9) 6 (26.1) Pandya [86] 75 37 (49.3) 20 (54.1) 38 (50.7) 18 (47.4) Roedl [87] 223 66 (29.6) 26 (39.4) 46 (20.6) 20 (43.5) Bavishi [88] 54 30 (55.6) 2 (6.7) 24 (44.4) 7 (29.2) COVID-ICU Group [89] 4244 2635 (62.1) 957 (36.3) 741 (17.5) 244 (32.9) Total 4978 7332 (38.2) 3351 (45.7) 1280 (6.7) 420 (37.2) The weighted means of the different studies are summarised in the final row. NA: data not available.
