Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe

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 adm...

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Autores: Jung, C, Fjolner, J, Bruno, RR, Wernly, B, Artigas, A, Pinto, BB, Schefold, JC, Wolff, G, Kelm, M, Beil, M, Sviri, S, van Heerden, PV, Szczeklik, W, Czuczwar, M, Joannidis, M, Oeyen, S, Zafeiridis, T, Andersen, FH, Moreno, R, Leaver, S, Boumendil, A, De Lange, DW, Guidet, B, Flaatten, H
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p1948
Acceso en línea:https://i3pt.portalinvestigacion.com/publicaciones/1948
Access Level:acceso abierto
Palabra clave:Covid-19
Frailty
Outcome
Elderly
Pandemia
Surges
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spelling Differences in mortality in critically ill elderly patients during the second COVID-19 surge in EuropeJung, CFjolner, JBruno, RRWernly, BArtigas, APinto, BBSchefold, JCWolff, GKelm, MBeil, MSviri, Svan Heerden, PVSzczeklik, WCzuczwar, MJoannidis, MOeyen, SZafeiridis, TAndersen, FHMoreno, RLeaver, SBoumendil, ADe Lange, DWGuidet, BFlaatten, HCovid-19FrailtyOutcomeElderlyPandemiaSurgesBackground: 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 PaO2/FiO(2) 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%). 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.BMC2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/1948CRITICAL CAREISSN: 13648535ISSNe: 1466609Xreponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p19482026-06-21T15:30:37Z
dc.title.none.fl_str_mv Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe
title Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe
spellingShingle Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe
Jung, C
Covid-19
Frailty
Outcome
Elderly
Pandemia
Surges
title_short Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe
title_full Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe
title_fullStr Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe
title_full_unstemmed Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe
title_sort Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe
dc.creator.none.fl_str_mv Jung, C
Fjolner, J
Bruno, RR
Wernly, B
Artigas, A
Pinto, BB
Schefold, JC
Wolff, G
Kelm, M
Beil, M
Sviri, S
van Heerden, PV
Szczeklik, W
Czuczwar, M
Joannidis, M
Oeyen, S
Zafeiridis, T
Andersen, FH
Moreno, R
Leaver, S
Boumendil, A
De Lange, DW
Guidet, B
Flaatten, H
author Jung, C
author_facet Jung, C
Fjolner, J
Bruno, RR
Wernly, B
Artigas, A
Pinto, BB
Schefold, JC
Wolff, G
Kelm, M
Beil, M
Sviri, S
van Heerden, PV
Szczeklik, W
Czuczwar, M
Joannidis, M
Oeyen, S
Zafeiridis, T
Andersen, FH
Moreno, R
Leaver, S
Boumendil, A
De Lange, DW
Guidet, B
Flaatten, H
author_role author
author2 Fjolner, J
Bruno, RR
Wernly, B
Artigas, A
Pinto, BB
Schefold, JC
Wolff, G
Kelm, M
Beil, M
Sviri, S
van Heerden, PV
Szczeklik, W
Czuczwar, M
Joannidis, M
Oeyen, S
Zafeiridis, T
Andersen, FH
Moreno, R
Leaver, S
Boumendil, A
De Lange, DW
Guidet, B
Flaatten, H
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Covid-19
Frailty
Outcome
Elderly
Pandemia
Surges
topic Covid-19
Frailty
Outcome
Elderly
Pandemia
Surges
description 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 PaO2/FiO(2) 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%). 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.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://i3pt.portalinvestigacion.com/publicaciones/1948
url https://i3pt.portalinvestigacion.com/publicaciones/1948
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv CRITICAL CARE
ISSN: 13648535
ISSNe: 1466609X
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
reponame_str r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
collection r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
repository.name.fl_str_mv
repository.mail.fl_str_mv
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