Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe.
Details
Serval ID
serval:BIB_7C4B85F7A1EF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe.
Journal
Critical care
Working group(s)
, COVIP Study Group
Contributor(s)
Eller P., Joannidis M., Mesotten D., Reper P., Oeyen S., Swinnen W., Brix H., Brushoej J., Villefrance M., Nedergaard H.K., Bjerregaard A.T., Balleby I.R., Andersen K., Hansen M.A., Uhrenholt S., Bundgaard H., Fjølner J., Mohamed AAH, Salah R., Ali YKNM, Wassim K., Elgazzar Y.A., Tharwat S., Azzam A.Y., Habib A.A., Abosheaishaa H.M., Azab M.A., Leaver S., Galbois A., Guidet B., Charron C., Guerot E., Besch G., Rigaud J.P., Maizel J., Djibré M., Burtin P., Garcon P., Nseir S., Valette X., Alexandru N., Marin N., Vaissiere M., Plantefeve G., Vanderlinden T., Jurcisin I., Megarbane B., Caillard A., Valent A., Garnier M., Besset S., Oziel J., Raphaelen J.H., Dauger S., Dumas G., Goncalves B., Piton G., Jung C., Bruno R.R., Kelm M., Wolff G., Barth E., Goebel U., Barth E., Kunstein A., Schuster M., Welte M., Lutz M., Meybohm P., Steiner S., Poerner T., Haake H., Schaller S., Kindgen-Milles D., Meyer C., Kurt M., Kuhn K.F., Randerath W., Wollborn J., Dindane Z., Kabitz H.J., Voigt I., Shala G., Faltlhauser A., Rovina N., Aidoni Z., Chrisanthopoulou E., Papadogoulas A., Gurjar M., Mahmoodpoor A., Ahmed A.K., Marsh B., Elsaka A., Sviri S., Comellini V., Rabha A., Ahmed H., Namendys-Silva S.A., Ghannam A., Groenendijk M., Zegers M., de Lange D., Cornet A., Evers M., Haas L., Dormans T., Dieperink W., Romundstad L., Sjøbø B., Andersen F.H., Strietzel H.F., Olasveengen T., Hahn M., Czuczwar M., Gawda R., Klimkiewicz J., de LurdesSantos M.C., Gordinho A., Santos H., Assis R., Oliveira AIP, Badawy M.R., Perez-Torres D., Gomà G., Villamayor M.I., Mira A.P., Cubero P.J., Rivera S.A., Tomasa T., Iglesias D., Vázquez E.M., Aldecoa C., Ferreira A.F., Zalba-Etayo B., Canas-Perez I., Tamayo-Lomas L., Diaz-Rodriguez C., Sancho S., Priego J., Abualqumboz EMY, Hilles MMY, Saleh M., Ben-HAmouda N., Roberti A., Dullenkopf A., Fleury Y., Pinto B.B., Schefold J.C., Al-Sadawi M., Serck N., Dewaele E., Kumar P., Bundesen C., Innes R., Gooch J., Cagova L., Potter E., Reay M., Davey M., Humphreys S., Berlemont C.H., Chousterman B.G., Dépret F., Ferre A., Vettoretti L., Thevenin D., Faltlhauser A., Milovanovic M., Simon P., Lorenz M., Stoll S.E., Dubler S., Fuest K., Mulita F., Kondili E., Andrianopoulos I., Meynaar I., Cornet A.D., Sjøbøe B., Kluzik A., Zatorski P., Drygalski T., Szczeklik W., Solek-Pastuszka J., Onichimowski D., Stefaniak J., Stefanska-Wronka K., Zabul E., Cardoso F.S., Banzo MJA, Tomasa-Irriguible T.M., Mira Á.P., Arias-Rivera S., Frutos-Vivar F., Lopez-Cuenca S., de Gopegui P.R., Abidi N., Chau I., Pugh R., Smuts S.
ISSN
1466-609X (Electronic)
ISSN-L
1364-8535
Publication state
Published
Issued date
23/09/2021
Peer-reviewed
Oui
Volume
25
Number
1
Pages
344
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Publication Status: epublish
Abstract
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 <sub>2</sub> /FiO <sub>2</sub> 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.
NCT04321265 , registered March 19th, 2020.
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 <sub>2</sub> /FiO <sub>2</sub> 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.
NCT04321265 , registered March 19th, 2020.
Keywords
Aged, Aged, 80 and over, COVID-19/mortality, Comorbidity, Critical Illness/mortality, Europe/epidemiology, Female, Frail Elderly, Humans, Intensive Care Units, Male, Organ Dysfunction Scores, Pandemics, Pneumonia, Viral/mortality, Pneumonia, Viral/virology, Prospective Studies, SARS-CoV-2, Survival Analysis, Covid-19, Elderly, Frailty, Outcome, Pandemia, Surges
Pubmed
Web of science
Create date
03/03/2022 21:19
Last modification date
23/11/2022 8:12
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