Caractéristiques des traitements en fonction du sexe et résultats de mortalité à 30 jours des patients atteints de COVID-19 gravement malades de plus de 70 ans—résultats de l’étude prospective COVIP

Translated title of the contribution: Sex-specific treatment characteristics and 30-day mortality outcomes of critically ill COVID-19 patients over 70 years of age—results from the prospective COVIP study

the COVIP Study Group

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Abstract

Purpose: Older critically ill patients with COVID-19 have been the most vulnerable during the ongoing pandemic, with men being more prone to hospitalization and severe disease than women. We aimed to explore sex-specific differences in treatment and outcome after intensive care unit (ICU) admission in this cohort. Methods: We performed a sex-specific analysis in critically ill patients ≥ 70 yr of age with COVID-19 who were included in the international prospective multicenter COVIP study. All patients were analyzed for ICU admission and treatment characteristics. We performed a multilevel adjusted regression analysis to elucidate associations of sex with 30-day mortality. Results: A total of 3,159 patients (69.8% male, 30.2% female; median age, 75 yr) were included. Male patients were significantly fitter than female patients as determined by the Clinical Frailty Scale (fit, 67% vs 54%; vulnerable, 14% vs 19%; frail, 19% vs 27%; P < 0.001). Male patients more often underwent tracheostomy (20% vs 14%; odds ratio [OR], 1.57; P < 0.001), vasopressor therapy (69% vs 62%; OR, 1.25; P = 0.02), and renal replacement therapy (17% vs 11%; OR, 1.96; P < 0.001). There was no difference in mechanical ventilation, life-sustaining treatment limitations, and crude 30-day mortality (50% male vs 49% female; OR, 1.11; P = 0.19), which remained true after adjustment for disease severity, frailty, age and treatment limitations (OR, 1.17; 95% confidence interval, 0.94 to 1.45; P = 0.16). Conclusion: In this analysis of sex-specific treatment characteristics and 30-day mortality outcomes of critically ill patients with COVID-19 ≥ 70 yr of age, we found more tracheostomy and renal replacement therapy in male vs female patients, but no significant association of patient sex with 30-day mortality. Study registration: www.ClinicalTrials.gov (NCT04321265); registered 25 March 2020).

Translated title of the contributionSex-specific treatment characteristics and 30-day mortality outcomes of critically ill COVID-19 patients over 70 years of age—results from the prospective COVIP study
Original languageFrench
Pages (from-to)1390-1398
JournalCanadian Journal of Anesthesia
Volume69
Issue number11
Early online date9 Aug 2022
DOIs
Publication statusPublished - Nov 2022

Keywords

  • COVID
  • COVIP
  • critical illness
  • elderly
  • mortality
  • sex

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