Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe.
Covid-19
Elderly
Frailty
Outcome
Pandemia
Surges
Journal
Critical care (London, England)
ISSN: 1466-609X
Titre abrégé: Crit Care
Pays: England
ID NLM: 9801902
Informations de publication
Date de publication:
23 09 2021
23 09 2021
Historique:
received:
17
06
2021
accepted:
19
08
2021
entrez:
24
9
2021
pubmed:
25
9
2021
medline:
1
10
2021
Statut:
epublish
Résumé
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 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. NCT04321265 , registered March 19th, 2020.
Sections du résumé
BACKGROUND
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.
METHODS
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).
RESULTS
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
CONCLUSION
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.
TRIAL REGISTRATION NUMBER
NCT04321265 , registered March 19th, 2020.
Identifiants
pubmed: 34556171
doi: 10.1186/s13054-021-03739-7
pii: 10.1186/s13054-021-03739-7
pmc: PMC8459701
doi:
Banques de données
ClinicalTrials.gov
['NCT04321265']
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
344Subventions
Organisme : h2020-infraeosc-05-2018-2019
ID : 831644
Investigateurs
Philipp Eller
(P)
Michael Joannidis
(M)
Dieter Mesotten
(D)
Pascal Reper
(P)
Sandra Oeyen
(S)
Walter Swinnen
(W)
Helene Brix
(H)
Jens Brushoej
(J)
Maja Villefrance
(M)
Helene Korvenius Nedergaard
(HK)
Anders Thais Bjerregaard
(AT)
Ida Riise Balleby
(IR)
Kasper Andersen
(K)
Maria Aagaard Hansen
(MA)
Stine Uhrenholt
(S)
Helle Bundgaard
(H)
Jesper Fjølner
(J)
Aliae Ar Hussein Mohamed
(AAH)
Rehab Salah
(R)
Yasmin Khairy NasrEldin Mohamed Ali
(YKNM)
Kyrillos Wassim
(K)
Yumna A Elgazzar
(YA)
Samar Tharwat
(S)
Ahmed Y Azzam
(AY)
Ayman Abdelmawgoad Habib
(AA)
Hazem Maarouf Abosheaishaa
(HM)
Mohammed A Azab
(MA)
Susannah Leaver
(S)
Arnaud Galbois
(A)
Bertrand Guidet
(B)
Cyril Charron
(C)
Emmanuel Guerot
(E)
Guillaume Besch
(G)
Jean-Philippe Rigaud
(JP)
Julien Maizel
(J)
Michel Djibré
(M)
Philippe Burtin
(P)
Pierre Garcon
(P)
Saad Nseir
(S)
Xavier Valette
(X)
Nica Alexandru
(N)
Nathalie Marin
(N)
Marie Vaissiere
(M)
Gaëtan Plantefeve
(G)
Thierry Vanderlinden
(T)
Igor Jurcisin
(I)
Buno Megarbane
(B)
Anais Caillard
(A)
Arnaud Valent
(A)
Marc Garnier
(M)
Sebastien Besset
(S)
Johanna Oziel
(J)
Jean-Herlé Raphaelen
(JH)
Stéphane Dauger
(S)
Guillaume Dumas
(G)
Bruno Goncalves
(B)
Gaël Piton
(G)
Christian Jung
(C)
Raphael Romano Bruno
(RR)
Malte Kelm
(M)
Georg Wolff
(G)
Eberhard Barth
(E)
Ulrich Goebel
(U)
Eberhard Barth
(E)
Anselm Kunstein
(A)
Michael Schuster
(M)
Martin Welte
(M)
Matthias Lutz
(M)
Patrick Meybohm
(P)
Stephan Steiner
(S)
Tudor Poerner
(T)
Hendrik Haake
(H)
Stefan Schaller
(S)
Detlef Kindgen-Milles
(D)
Christian Meyer
(C)
Muhammed Kurt
(M)
Karl Friedrich Kuhn
(KF)
Winfried Randerath
(W)
Jakob Wollborn
(J)
Zouhir Dindane
(Z)
Hans-Joachim Kabitz
(HJ)
Ingo Voigt
(I)
Gonxhe Shala
(G)
Andreas Faltlhauser
(A)
Nikoletta Rovina
(N)
Zoi Aidoni
(Z)
Evangelia Chrisanthopoulou
(E)
Antonios Papadogoulas
(A)
Mohan Gurjar
(M)
Ata Mahmoodpoor
(A)
Abdullah Khudhur Ahmed
(AK)
Brian Marsh
(B)
Ahmed Elsaka
(A)
Sigal Sviri
(S)
Vittoria Comellini
(V)
Ahmed Rabha
(A)
Hazem Ahmed
(H)
Silvio A Namendys-Silva
(SA)
Abdelilah Ghannam
(A)
Martijn Groenendijk
(M)
Marieke Zegers
(M)
Dylan de Lange
(D)
Alex Cornet
(A)
Mirjam Evers
(M)
Lenneke Haas
(L)
Tom Dormans
(T)
Willem Dieperink
(W)
Luis Romundstad
(L)
Britt Sjøbø
(B)
Finn H Andersen
(FH)
Hans Frank Strietzel
(HF)
Theresa Olasveengen
(T)
Michael Hahn
(M)
Miroslaw Czuczwar
(M)
Ryszard Gawda
(R)
Jakub Klimkiewicz
(J)
Maria Campos de LurdesSantos
(MC)
André Gordinho
(A)
Henrique Santos
(H)
Rui Assis
(R)
Ana Isabel Pinho Oliveira
(AIP)
Mohamed Raafat Badawy
(MR)
David Perez-Torres
(D)
Gemma Gomà
(G)
Mercedes Ibarz Villamayor
(MI)
Angela Prado Mira
(AP)
Patricia Jimeno Cubero
(PJ)
Susana Arias Rivera
(SA)
Teresa Tomasa
(T)
David Iglesias
(D)
Eric Mayor Vázquez
(EM)
Cesar Aldecoa
(C)
Aida Fernández Ferreira
(AF)
Begoña Zalba-Etayo
(B)
Isabel Canas-Perez
(I)
Luis Tamayo-Lomas
(L)
Cristina Diaz-Rodriguez
(C)
Susana Sancho
(S)
Jesús Priego
(J)
Enas M Y Abualqumboz
(EMY)
Momin Majed Yousuf Hilles
(MMY)
Mahmoud Saleh
(M)
Nawfel Ben-HAmouda
(N)
Andrea Roberti
(A)
Alexander Dullenkopf
(A)
Yvan Fleury
(Y)
Bernardo Bollen Pinto
(BB)
Joerg C Schefold
(JC)
Mohammed Al-Sadawi
(M)
Nicolas Serck
(N)
Elisabeth Dewaele
(E)
Pritpal Kumar
(P)
Camilla Bundesen
(C)
Richard Innes
(R)
James Gooch
(J)
Lenka Cagova
(L)
Elizabeth Potter
(E)
Michael Reay
(M)
Miriam Davey
(M)
Sally Humphreys
(S)
Caroline Hauw Berlemont
(CH)
Benjamin Glenn Chousterman
(BG)
François Dépret
(F)
Alexis Ferre
(A)
Lucie Vettoretti
(L)
Didier Thevenin
(D)
Andreas Faltlhauser
(A)
Milena Milovanovic
(M)
Philipp Simon
(P)
Marco Lorenz
(M)
Sandra Emily Stoll
(SE)
Simon Dubler
(S)
Kristina Fuest
(K)
Francesk Mulita
(F)
Eumorifa Kondili
(E)
Ioannis Andrianopoulos
(I)
Iwan Meynaar
(I)
Alexander Daniel Cornet
(AD)
Britt Sjøbøe
(B)
Anna Kluzik
(A)
Paweł Zatorski
(P)
Tomasz Drygalski
(T)
Wojciech Szczeklik
(W)
Joanna Solek-Pastuszka
(J)
Dariusz Onichimowski
(D)
Jan Stefaniak
(J)
Karina Stefanska-Wronka
(K)
Ewa Zabul
(E)
Filipe Sousa Cardoso
(FS)
Maria José Arche Banzo
(MJA)
Teresa Maria Tomasa-Irriguible
(TM)
Ángela Prado Mira
(ÁP)
Susana Arias-Rivera
(S)
Fernando Frutos-Vivar
(F)
Sonia Lopez-Cuenca
(S)
Pablo Ruiz de Gopegui
(PR)
Nour Abidi
(N)
Ivan Chau
(I)
Richard Pugh
(R)
Sara Smuts
(S)
Informations de copyright
© 2021. The Author(s).
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