Thread by @WhistlingDixie4

Learning points from @ESICM webinar on #COVID19 (based on experience in China)

- 10% of all cases had GI symptoms in the first week

-80% OF CASES WERE MILD

- 5% of all cases were 'critical' and needed ICU (respiratory failure on air, shock or other organ failure)
(thread)

- In ICU patients, prolonged steroid course may lead to longer virus shedding time.

- 50% of the ICU pts had high Troponin related to myocardial virulence of #coronovirus. They saw some sudden, resistant cardiogenic collapse

- They have not seen an increased risk of illness in pregnant or lactating female. This is different from what we know about influenza

- The most associated co-morbities with ICU admission were diabetes and hypertension. (Hypertension was associated the most)

- There is agreement with the @WHO interim advice that there should be a low threshold for considering NIV/HFNO trial failed and proceeding to intubation early

- Management is as per ARDS; NMB, recruitment strategies, early proning...

-In ICU pts, they've seen a worsening of ventilatory failure with refractory hypercapnia in week 3

- Autopsy results suggest this is 2' to secretion retention as well as dead space ventilation

And finally - drills for putting on and (perhaps more importantly taking off) protective equipment and clothing are important for staff....

not just to prevent spread

...but also to afford staff an element of psychological safety

Thanks again @ESICM #COVD19 #Coronavirus

@ESICM PS - the @TheLancet have resource page including early epidemiological data here:
thelancet.com/coronavirus

And you can find more info and links to papers published in @yourICM here
esicm.org/resources/coro…