RT Journal Article SR Electronic T1 Clinical characteristics, risk factors and outcomes in patients with severe COVID-19 registered in the International Severe Acute Respiratory and Emerging Infection Consortium WHO clinical characterisation protocol: a prospective, multinational, multicentre, observational study JF ERJ Open Research JO erjor FD European Respiratory Society SP 00552-2021 DO 10.1183/23120541.00552-2021 VO 8 IS 1 A1 Reyes, Luis Felipe A1 Murthy, Srinivas A1 Garcia-Gallo, Esteban A1 Irvine, Mike A1 Merson, Laura A1 Martin-Loeches, Ignacio A1 Rello, Jordi A1 Taccone, Fabio S. A1 Fowler, Robert A. A1 Docherty, Annemarie B. A1 Kartsonaki, Christiana A1 Aragao, Irene A1 Barrett, Peter W. A1 Beane, Abigail A1 Burrell, Aidan A1 Cheng, Matthew Pellan A1 Christian, Michael D. A1 Cidade, Jose Pedro A1 Citarella, Barbara Wanjiru A1 Donnelly, Christl A. A1 Fernandes, Susana M. A1 French, Craig A1 Haniffa, Rashan A1 Harrison, Ewen M. A1 Ho, Antonia Ying Wai A1 Joseph, Mark A1 Khan, Irfan A1 Kho, Michelle E. A1 Kildal, Anders Benjamin A1 Kutsogiannis, Demetrios A1 Lamontagne, François A1 Lee, Todd C. A1 Bassi, Gianluigi Li A1 Lopez Revilla, Jose Wagner A1 Marquis, Catherine A1 Millar, Jonathan A1 Neto, Raul A1 Nichol, Alistair A1 Parke, Rachael A1 Pereira, Rui A1 Poli, Sergio A1 Povoa, Pedro A1 Ramanathan, Kollengode A1 Rewa, Oleksa A1 Riera, Jordi A1 Shrapnel, Sally A1 Silva, Maria Joao A1 Udy, Andrew A1 Uyeki, Timothy A1 Webb, Steve A. A1 Wils, Evert-Jan A1 Rojek, Amanda A1 Olliaro, Piero L. A1 ISARIC Clinical Characterisation Group YR 2022 UL http://openres.ersjournals.com/content/8/1/00552-2021.abstract AB Due to the large number of patients with severe coronavirus disease 2019 (COVID-19), many were treated outside the traditional walls of the intensive care unit (ICU), and in many cases, by personnel who were not trained in critical care. The clinical characteristics and the relative impact of caring for severe COVID-19 patients outside the ICU is unknown. This was a multinational, multicentre, prospective cohort study embedded in the International Severe Acute Respiratory and Emerging Infection Consortium World Health Organization COVID-19 platform. Severe COVID-19 patients were identified as those admitted to an ICU and/or those treated with one of the following treatments: invasive or noninvasive mechanical ventilation, high-flow nasal cannula, inotropes or vasopressors. A logistic generalised additive model was used to compare clinical outcomes among patients admitted or not to the ICU. A total of 40 440 patients from 43 countries and six continents were included in this analysis. Severe COVID-19 patients were frequently male (62.9%), older adults (median (interquartile range (IQR), 67 (55–78) years), and with at least one comorbidity (63.2%). The overall median (IQR) length of hospital stay was 10 (5–19) days and was longer in patients admitted to an ICU than in those who were cared for outside the ICU (12 (6–23) days versus 8 (4–15) days, p<0.0001). The 28-day fatality ratio was lower in ICU-admitted patients (30.7% (5797 out of 18 831) versus 39.0% (7532 out of 19 295), p<0.0001). Patients admitted to an ICU had a significantly lower probability of death than those who were not (adjusted OR 0.70, 95% CI 0.65–0.75; p<0.0001). Patients with severe COVID-19 admitted to an ICU had significantly lower 28-day fatality ratio than those cared for outside an ICU.Countries and hospitals need to identify strategies to increase their ICU capacity (i.e. trained personnel, ICU beds and monitoring systems) to treat patients presenting to the hospital with severe #COVID19 rather than provide such care outside of the ICU https://bit.ly/3xh9A6M