Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe
Jung, Christian (Heinrich-Heine-University Duesseldorf)
Fjølner, Jesper (Aarhus University Hospital (Aarhus, Dinamarca))
Bruno, Raphael Romano (Heinrich-Heine-University Duesseldorf)
Wernly, Bernhard (Paracelsus Medical University)
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Bollen Pinto, Bernardo (Geneva University Hospitals)
Schefold, Joerg C. (University of Bern)
Wolff, Georg (Heinrich-Heine-University Duesseldorf)
Kelm, Malte (Heinrich-Heine-University Duesseldorf)
Beil, Michael (Hebrew University of Jerusalem)
Sviri, Sigal (Hebrew University of Jerusalem)
van Heerden, Peter Vernon (Hadassah University Medical Center)
Szczeklik, Wojciech (Jagiellonian University Medical College)
Czuczwar, Miroslaw (Medical University of Lublin)
Joannidis, Michael (Medical University Innsbruck)
Oeyen, Sandra (Universitair Ziekenhuis Gent)
Zafeiridis, Tilemachos (General University Hospital of Larissa (Grècia))
Andersen, Finn H. (Norwegian University of Science and Technology)
Moreno, Rui (Centro Hospitalar Universitário de Lisboa Central)
Leaver, Susannah (St George's University Hospital NHS Foundation Trust)
Boumendil, Ariane (Hôpital Saint-Antoine)
De Lange, Dylan W. (University Utrecht)
Guidet, Bertrand (Hôpital Saint-Antoine)
Flaatten, Hans (University of Bergen)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	The primary aim of this study was to assess the outcome of elderly intensive care unit (ICU) patients treated during the spring and autumn COVID-19 surges in Europe. This was a prospective European observational study (the COVIP study) in ICU patients aged 70 years and older admitted with COVID-19 disease from March to December 2020 to 159 ICUs in 14 European countries. An electronic database was used to register a number of parameters including: SOFA score, Clinical Frailty Scale, co-morbidities, usual ICU procedures and survival at 90 days. The study was registered at ClinicalTrials. gov (NCT04321265). In total, 2625 patients were included, 1327 from the first and 1298 from the second surge. Median age was 74 and 75 years in surge 1 and 2, respectively. SOFA score was higher in the first surge (median 6 versus 5, p < 0. 0001). The PaO/FiO ratio at admission was higher during surge 1, and more patients received invasive mechanical ventilation (78% versus 68%, p < 0. 0001). During the first 15 days of treatment, survival was similar during the first and the second surge. Survival was lower in the second surge after day 15 and differed after 30 days (57% vs 50%) as well as after 90 days (51% vs 40%). An unexpected, but significant, decrease in 30-day and 90-day survival was observed during the second surge in our cohort of elderly ICU patients. The reason for this is unclear. Our main concern is whether the widespread changes in practice and treatment of COVID-19 between the two surges have contributed to this increased mortality in elderly patients. Further studies are urgently warranted to provide more evidence for current practice in elderly patients. , registered March 19th, 2020. The online version contains supplementary material available at 10. 1186/s13054-021-03739-7.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Covid-19 ; Elderly ; Frailty ; Outcome ; Pandemia ; Surges
Publicat a:	Critical Care, Vol. 25 (september 2021) , ISSN 1466-609X

DOI: 10.1186/s13054-021-03739-7
PMID: 34556171

12 p, 1.6 MB

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