Critically Ill Adults With Coronavirus Disease 2019 in New Orleans and Care With an Evidence-Based Protocol

David R. Janz, Scott Mackey, Nirav Patel, Beau P. Saccoccia, Michelle St. Romain, Bethany Busack, Hayoung Lee, Lana Phan, Jordan Vaughn, David Feinswog, Ryan Chan, Lauren Auerbach, Nicholas Sausen, Joseph Grace, Marian Sackey, Anushka Das, Angellica O. Gordon, Jennifer Schwehm, Robin McGoey, Kyle I. HappelStephen P. Kantrow

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background: Characteristics of critically ill adults with coronavirus disease 2019 (COVID-19) in an academic safety net hospital and the effect of evidence-based practices in these patients are unknown. Research Question: What are the outcomes of critically ill adults with COVID-19 admitted to a network of hospitals in New Orleans, Louisiana, and what is an evidence-based protocol for care associated with improved outcomes? Study Design and Methods: In this multi-center, retrospective, observational cohort study of ICUs in four hospitals in New Orleans, Louisiana, we collected data on adults admitted to an ICU and tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between March 9, 2020 and April 14, 2020. The exposure of interest was admission to an ICU that implemented an evidence-based protocol for COVID-19 care. The primary outcome was ventilator-free days. Results: The initial 147 patients admitted to any ICU and tested positive for SARS-CoV-2 constituted the cohort for this study. In the entire network, exposure to an evidence-based protocol was associated with more ventilator-free days (25 days; 0-28) compared with non-protocolized ICUs (0 days; 0-23, P =.005), including in adjusted analyses (P =.02). Twenty patients (37%) admitted to protocolized ICUs died compared with 51 (56%; P =.02) in non-protocolized ICUs. Among 82 patients admitted to the academic safety net hospital's ICUs, the median number of ventilator-free days was 22 (interquartile range, 0-27) and mortality rate was 39%. Interpretation: Care of critically ill COVID-19 patients with an evidence-based protocol is associated with increased time alive and free of invasive mechanical ventilation. In-hospital survival occurred in most critically ill adults with COVID-19 admitted to an academic safety net hospital's ICUs despite a high rate of comorbidities.

Original languageEnglish (US)
Pages (from-to)196-204
Number of pages9
Issue number1
StatePublished - Jan 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 American College of Chest Physicians


  • ARDS
  • COVID-19
  • critical care


Dive into the research topics of 'Critically Ill Adults With Coronavirus Disease 2019 in New Orleans and Care With an Evidence-Based Protocol'. Together they form a unique fingerprint.

Cite this