BACKGROUND Community transmission of coronavirus 2019 (Covid-19) was detected in the state of Washington in February 2020. METHODS We identified patients from nine Seattle-area hospitals who were admitted to the intensive care unit (ICU) with confirmed infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Clinical data were obtained through review of medical records. The data reported here are those available through March 23, 2020. Each patient had at least 14 days of follow-up. RESULTS We identified 24 patients with confirmed Covid-19. The mean (±SD) age of the patients was 64±18 years, 63% were men, and symptoms began 7±4 days before admission. The most common symptoms were cough and shortness of breath; 50% of patients had fever on admission, and 58% had diabetes mellitus. All the patients were admitted for hypoxemic respiratory failure; 75% (18 patients) needed mechanical ventilation. Most of the patients (17) also had hypotension and needed vasopressors. No patient tested positive for influenza A, influenza B, or other respiratory viruses. Half the patients (12) died between ICU day 1 and day 18, including 4 patients who had a do-not-resuscitate order on admission. Of the 12 surviving patients, 5 were discharged home, 4 were discharged from the ICU but remained in the hospital, and 3 continued to receive mechanical ventilation in the ICU. CONCLUSIONS During the first 3 weeks of the Covid-19 outbreak in the Seattle area, the most common reasons for admission to the ICU were hypoxemic respiratory failure leading to mechanical ventilation, hypotension requiring vasopressor treatment, or both. Mortality among these critically ill patients was high. (Funded by the National Institutes of Health.).

中文翻译：

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西雅图地区重症患者中的 Covid-19 - 病例系列。

背景 2020 年 2 月，华盛顿州发现了 2019 年冠状病毒 (Covid-19) 的社区传播。方法 我们确定了来自西雅图地区 9 家医院的重症监护病房 (ICU) 确诊感染严重急性呼吸道疾病的患者。冠状病毒-2 综合征 (SARS-CoV-2)。通过审查医疗记录获得临床数据。这里报告的数据截至 2020 年 3 月 23 日。每位患者至少接受了 14 天的随访。结果 我们确定了 24 名确诊为 Covid-19 的患者。患者的平均 (±SD) 年龄为 64±18 岁，63% 为男性，症状于入院前 7±4 天开始。最常见的症状是咳嗽和气短；50%的患者入院时有发烧症状，58%患有糖尿病。所有患者均因低氧性呼吸衰竭入院；75%（18 名患者）需要机械通气。大多数患者 (17) 还患有低血压，需要血管加压药。没有患者甲型流感、乙型流感或其他呼吸道病毒检测呈阳性。一半患者（12 名）在 ICU 第 1 天到第 18 天之间死亡，其中 4 名患者在入院时收到了不复苏令。12名幸存患者中，5人出院回家，4人出院但仍留在医院，3人继续在ICU接受机械通气。结论 在西雅图地区 Covid-19 爆发的前 3 周内，入住 ICU 的最常见原因是导致机械通气的低氧血症性呼吸衰竭、需要升压药治疗的低血压，或两者兼而有之。这些重症患者的死亡率很高。（由美国国立卫生研究院资助）。