COVID-19 in London, a Case Series Demonstrating Late Improvement in Survivors

ObjectiveTo determine whether the trajectories of survivors and non-survivors are different in patients admitted to intensive care in London. DesignIn this case series of 15 survivors and 16 non-survivors, data from admission to discharge was collected and aligned to lowest PaO2/FiO2 ratio where aggregation and trends were demonstrated. SettingSingle centre case-series in London, Intensive Care. ParticipantsAll non-survivors were included (n = 16). A biased set of survivors (n = 15) who were demonstrated an unexpected and rapid recovery after a prolonged period of mechanical ventilatory support. ResultsRespiratory failure trajectories of survivors and non-survivors were similar once aligned indicating, from a respiratory function perspective, it is difficult to identify survivors from non-survivors with some survivors improving late in their disease (day 20 - 30 from symptom onset) Non-survivors are admitted earlier in their disease (p<0.05) and had worse organ failure requirements prior to the nadir of their respiratory funciton (p<0.05) compard to survivors. ConclusionAnalysis of multiple factors fails to differentiate between survivors and non-survivors. Even when faced with multiorgan failure, perseverance until discharge must be advocated as late improvements do occur in survivors.