TY - JOUR
T1 - Differences in mortality in critically ill elderly patients during the second COVID-19 surge in Europe
AU - COVIP Study Group
AU - Jung, Christian
AU - Fjølner, Jesper
AU - Bruno, Raphael Romano
AU - Wernly, Bernhard
AU - Artigas, Antonio
AU - Bollen Pinto, Bernardo
AU - Schefold, Joerg C.
AU - Wolff, Georg
AU - Kelm, Malte
AU - Beil, Michael
AU - Sviri, Sigal
AU - van Heerden, Peter Vernon
AU - Szczeklik, Wojciech
AU - Czuczwar, Miroslaw
AU - Joannidis, Michael
AU - Oeyen, Sandra
AU - Zafeiridis, Tilemachos
AU - Andersen, Finn H.
AU - Moreno, Rui
AU - Leaver, Susannah
AU - Boumendil, Ariane
AU - De Lange, Dylan W.
AU - Guidet, Bertrand
AU - Flaatten, Hans
AU - Eller, Philipp
AU - Mesotten, Dieter
AU - Reper, Pascal
AU - Swinnen, Walter
AU - Brix, Helene
AU - Brushoej, Jens
AU - Villefrance, Maja
AU - Nedergaard, Helene Korvenius
AU - Bjerregaard, Anders Thais
AU - Balleby, Ida Riise
AU - Andersen, Kasper
AU - Hansen, Maria Aagaard
AU - Uhrenholt, Stine
AU - Bundgaard, Helle
AU - Mohamed, Aliae AR Hussein
AU - Salah, Rehab
AU - Ali, Yasmin Khairy Nasr Eldin Mohamed
AU - Wassim, Kyrillos
AU - Elgazzar, Yumna A.
AU - Tharwat, Samar
AU - Azzam, Ahmed Y.
AU - Habib, Ayman abdelmawgoad
AU - Abosheaishaa, Hazem Maarouf
AU - Azab, Mohammed A.
AU - Galbois, Arnaud
AU - Cardoso, Filipe Sousa
N1 - Funding Information:
Open Access funding enabled and organized by Projekt DEAL. The support of the study in France by a grant from Fondation Assistance Publique-Hôpitaux de Paris pour la recherche is greatly appreciated. In Norway, the study was supported by a grant from the Health Region West. In addition, the study was funded by a grant from the European Open Science Cloud (EOSC) by the European Commission. No further specific funding was received.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - 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/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%). 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. Trial registration number: NCT04321265, registered March 19th, 2020.
AB - 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/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%). 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. Trial registration number: NCT04321265, registered March 19th, 2020.
KW - Covid-19
KW - Elderly
KW - Frailty
KW - Outcome
KW - Pandemia
KW - Surges
UR - http://www.scopus.com/inward/record.url?scp=85115861355&partnerID=8YFLogxK
U2 - 10.1186/s13054-021-03739-7
DO - 10.1186/s13054-021-03739-7
M3 - Article
C2 - 34556171
AN - SCOPUS:85115861355
SN - 1364-8535
VL - 25
JO - Critical Care
JF - Critical Care
IS - 1
M1 - 344
ER -