ObjectivesTo evaluate the factors associated with mortality in mechanically ventilated
patients with acute respiratory distress syndrome due to COVID-19.MethodsThis was a retrospective, multicenter cohort study that included 425
mechanically ventilated adult patients with COVID-19 admitted to 4 intensive
care units. Clinical data comprising the SOFA score, laboratory data and
mechanical characteristics of the respiratory system were collected in a
standardized way immediately after the start of invasive mechanical
ventilation. The risk factors for death were analyzed using Cox regression
to estimate the risk ratios and their respective 95%CIs.ResultsBody mass index (RR 1.17; 95%CI 1.11 - 1.20; p < 0.001), SOFA score (RR
1.39; 95%CI 1.31 - 1.49; p < 0.001) and driving pressure (RR 1.24; 95%CI
1.21 - 1.29; p < 0.001) were considered independent factors associated
with mortality in mechanically ventilated patients with acute respiratory
distress syndrome due to COVID-19. Respiratory system compliance (RR 0.92;
95%CI 0.90 - 0.93; p < 0.001) was associated with lower mortality. The
comparative analysis of the survival curves indicated that patients with
respiratory system compliance (< 30mL/cmH2O), a higher SOFA
score (> 5 points) and higher driving pressure (> 14cmH2O)
were more significantly associated with the outcome of death at 28 days and
60 days.ConclusionPatients with a body mass index > 32kg/m2, respiratory system
compliance < 30mL/cmH2O, driving pressure >
14cmH2O and SOFA score > 5.8 immediately after the
initiation of invasive ventilatory support had worse outcomes, and
independent risk factors were associated with higher mortality in this
population.