PURPOSE Montreal has been the epicentre of the coronavirus disease (COVID-19) pandemic in Canada . Given the regional disparities in incidence and mortality in the general population, we aimed to describe local characteristics, treatments, and outcomes of critically ill COVID-19 patients in Montreal .
METHODS A single-centre retrospective cohort of consecutive adult patients admitted to the intensive care unit (ICU) of Hôpital du Sacré-Coeur de Montréal with confirmed COVID-19 were included .
RESULTS Between 20 March and 13 May 2020, 75 patients were admitted, with a median [interquartile range (IQR) ] age of 62 [53-72] yr and high rates of obesity (47 %), hypertension (67 %), and diabetes (37 %). Healthcare-related infections were responsible for 35% of cases . The median [IQR] day 1 sequential organ failure assessment score was 6 [3-7]. Invasive mechanical ventilation (IMV) was used in 57% of patients for a median [IQR] of 11 [5-22] days . Patients receiving IMV were characterized by a moderately decreased median [IQR] partial pressure of oxygen: fraction of inspired oxygen (day 1 PaO: FO = 177 [138-276]; day 10 = 173 [147-227] ) and compliance (day 1 = 48 [38-58] mL/cmHO; day 10 = 34 [28-42] mL/cmHO) and very elevated estimated dead space fraction (day 1 = 0.60 [0.53-0.67]; day 10 = 0.72 [0.69-0.79] ). Overall hospital mortality was 25%, and 21% in the IMV patients . Mortality was 82% in patients ≥ 80 yr old .
CONCLUSIONS Characteristics and outcomes of critically ill patients with COVID-19 in Montreal were similar to those reported in the existing literature . We found an increased physiologic dead space, supporting the hypothesis that pulmonary vascular injury may be central to COVID-19-induced lung damage.