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

2021; BioMed Central; Volume: 25; Issue: 1 Linguagem: Inglês

10.1186/s13054-021-03739-7

1466-609X

Christian Jung, Jesper Fjølner, Raphael Romano Bruno, Bernhard Wernly, Antonio Artigas, Bernardo Bollen Pinto, Joerg C. Schefold, Georg Wolff, Malte Kelm, Michael Beil, Sigal Sviri, Peter Vernon van Heerden, Wojciech Szczeklik, Mirosław Czuczwar, Michael Joannidis, Sandra Oeyen, Tilemachos Zafeiridis, Finn H. Andersen, Rui P. Moreno, Susannah Leaver, Ariane Boumendil, Dylan W. de Lange, Bertrand Guidet, Hans Flaatten, Philipp Eller, Michael Joannidis, Dieter Mesotten, P. Reper, Sandra Oeyen, Walter Swinnen, Helene Brix, Jens Brushoej, Maja Villefrance, Helene Korvenius Nedergaard, Anders Thais Bjerregaard, Ida Riise Balleby, Kasper H. Andersen, Maria Aagaard Hansen, Stine Uhrenholt, Henning Bundgaard, Jesper Fjølner, Aliae Ar Hussein Mohamed, Rehab Salah, Yasmin Khairy NasrEldin Mohamed Ali, Kyrillos Wassim, Yumna A Elgazzar, Samar Tharwat, Ahmed Y. Azzam, Ayman Abdelmawgoad Habib, Hazem Abosheaishaa, Mohammed A. Azab, Susannah Leaver, Arnaud Galbois, Bertrand Guidet, Cyril Charron, Emmanuel Guérot, Guillaume Besch, Jean‐Philippe Rigaud, Julien Maizel, Michel Djibré, Philippe Burtin, Pierre Garçon, Saad Nseir, Xavier Valette, Nica Alexandru, Nathalie Marin, Marie Vaissiere, Gaëtan Plantefève, Thierry Vanderlinden, Igor Jurcisin, Buno Mégarbane, Anaïs Caillard, Arnaud Valent, Marc Garnier, Sébastien Besset, Johanna Oziel, Jean-Herlé Raphaelen, Stéphane Dauger, Guillaume Dumas, Bruno Gonçalves, Gaël Piton, Christian Jung, Raphael Romano Bruno, Malte Kelm, Georg Wolff, Eberhard Barth, Hans H. Goebel, Eberhard Barth, Anselm Kunstein, Michael Schuster, M. Welte, Matthias Lutz, Patrick Meybohm, Stephan Steiner, Tudor C. Poerner, Hendrik Haake, Stefan J. Schaller, Detlef Kindgen‐Milles, Christian Meyer, Muhammed Kurt, Karl Friedrich Kuhn, Winfried Randerath, Jakob Wollborn, Zouhir Dindane, Hans‐Joachim Kabitz, Ingo Voigt, Gonxhe Shala, Andreas Faltlhauser, Νikoletta Ρovina, Zoi Aidoni, Evangelia Chrisanthopoulou, Antonio Artigas, Mohan Gurjar, Ata Mahmoodpoor, Abdullah Khudhur Ahmed, Brian Marsh, Ahmed Elsaka, Sigal Sviri, Vittoria Comellini, Ahmed Rabha, Hazem A. Sayed Ahmed, Silvio A. Ñamendys‐Silva, Abdelilah Ghannam, Martijn Groenendijk, Marieke Zegers, Dylan W. de Lange, Alex Cornet, Mirjam Evers, Lenneke Haas, Tom Dormans, Willem Dieperink, Luis Romundstad, Britt Sjøbø, Finn H. Andersen, Hans Frank Strietzel, Theresa M. Olasveengen, Michael Hahn, Mirosław Czuczwar, Ryszard Gawda, Jakub Klimkiewicz, Maria Campos de LurdesSantos, André Gordinho, Lurdes Santos, Rui Assis, Ana Andrade Oliveira, Mohamed Raafat Badawy, David Pérez-Torres, Gemma Gomà, Mercedes Ibarz Villamayor, Ángela Prado Mira, Patricia Jimeno Cubero, S. Arias-Rivera, Teresa Tomasa, David A. Iglesias, Eric Mayor Vázquez, César Aldecoa, Aida Fernández Ferreira, Begoña Zalba-Etayo, Isabel Canas-Pérez, Luis Tamayo-Lomas, Cristina Díaz-Rodríguez, Susana Sancho, Jesús Priego, Enas M. Y. Abualqumboz, Momin Majed Yousuf Hilles, Mahmoud Saleh, Nawfel Ben‐Hamouda, Andrea Roberti, Alexander Dullenkopf, Yvan Fleury, Bernardo Bollen Pinto, Joerg C. Schefold, Mohammed Al‐Sadawi, Nicolas Serck, Elisabeth Dewaele, Pritpal Kumar, Camilla Bundesen, Richard Innes, James Gooch, Lenka Cagova, Elizabeth Potter, Michael Reay, Miriam Davey, Sally Humphreys, Caroline Hauw Berlemont, Benjamin G. Chousterman, François Dépret, Alexis Ferré, Lucie Vettoretti, Didier Thévenin, Andreas Faltlhauser, Milena Milovanovic, Philipp W. Simon, Marco Lorenz, Sandra Emily Stoll, Simon Dubler, Kristina Fuest, Francesk Mulita, Eumorifa Kondili, Ioannis Andrianopoulos, Iwan A. Meynaar, Alexander D. Cornet, Britt Sjøbøe, Anna Kluzik, Paweł Zatorski, Tomasz Drygalski, Wojciech Szczeklik, Joanna Sołek-Pastuszka, Dariusz Onichimowski, Jan Stefaniak, Karina Stefańska-Wronka, Ewa Zabul, Filipe S. Cardoso, María José Arche Banzo, Teresa Maria Tomasa-Irriguible, Ángela Prado Mira, S. Arias-Rivera, Fernando Frutos‐Vivar, Sonia López‐Cuenca, Pablo Ruiz de Gopegui, Nour Abidi, Ivan Chau, Richard Pugh, Sara Smuts,

Intensive Care Unit Cognitive Disorders

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 PaO2/FiO2 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.