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