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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.
Reyes, Luis Felipe; Murthy, Srinivas; Garcia-Gallo, Esteban; Irvine, Mike; Merson, Laura; Martin-Loeches, Ignacio; Rello, Jordi; Taccone, Fabio S; Fowler, Robert A; Docherty, Annemarie B; Kartsonaki, Christiana; Aragao, Irene; Barrett, Peter W; Beane, Abigail; Burrell, Aidan; Cheng, Matthew Pellan; Christian, Michael D; Cidade, Jose Pedro; Citarella, Barbara Wanjiru; Donnelly, Christl A; Fernandes, Susana M; French, Craig; Haniffa, Rashan; Harrison, Ewen M; Ho, Antonia Ying Wai; Joseph, Mark; Khan, Irfan; Kho, Michelle E; Kildal, Anders Benjamin; Kutsogiannis, Demetrios; Lamontagne, François; Lee, Todd C; Bassi, Gianluigi Li; Lopez Revilla, Jose Wagner; Marquis, Catherine; Millar, Jonathan; Neto, Raul; Nichol, Alistair; Parke, Rachael; Pereira, Rui; Poli, Sergio; Povoa, Pedro; Ramanathan, Kollengode; Rewa, Oleksa; Riera, Jordi; Shrapnel, Sally; Silva, Maria Joao; Udy, Andrew; Uyeki, Timothy; Webb, Steve A.
  • Reyes LF; Universidad de La Sabana, Chía, Colombia.
  • Murthy S; Nuffield Dept of Medicine, University of Oxford, Oxford, UK.
  • Garcia-Gallo E; British Columbia Children's Hospital, Vancouver, BC, Canada.
  • Irvine M; Universidad de La Sabana, Chía, Colombia.
  • Merson L; British Columbia Centre for Disease Control, Vancouver, BC, Canada.
  • Martin-Loeches I; Nuffield Dept of Medicine, University of Oxford, Oxford, UK.
  • Rello J; Intensive Care Medicine, St James's Hospital, Dublin, Ireland.
  • Taccone FS; Vall d'Hebron Institute of Research, Barcelona, Spain.
  • Fowler RA; Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
  • Docherty AB; Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
  • Kartsonaki C; Nuffield Dept of Medicine, University of Oxford, Oxford, UK.
  • Aragao I; Nuffield Dept of Medicine, University of Oxford, Oxford, UK.
  • Barrett PW; Centro Hospitalar Universitário do Porto, Porto, Portugal.
  • Beane A; Piedmont Atlanta Hospital, Atlanta, GA, USA.
  • Burrell A; Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.
  • Cheng MP; Monash University, Melbourne, Australia.
  • Christian MD; McGill University, Hamilton, ON, Canada.
  • Cidade JP; Bart's NHS Health Trust, London, UK.
  • Citarella BW; Hospital São Francisco Xavier, Lisbon, Portugal.
  • Donnelly CA; Nuffield Dept of Medicine, University of Oxford, Oxford, UK.
  • Fernandes SM; Nuffield Dept of Medicine, University of Oxford, Oxford, UK.
  • French C; Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.
  • Haniffa R; Western Health, Melbourne, Australia.
  • Harrison EM; Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.
  • Ho AYW; Nuffield Dept of Medicine, University of Oxford, Oxford, UK.
  • Joseph M; Nuffield Dept of Medicine, University of Oxford, Oxford, UK.
  • Khan I; Carilion Clinic, Roanoke, VA, USA.
  • Kho ME; Presbyterian Hospital Services, Albuquerque, NM, USA.
  • Kildal AB; McGill University, Hamilton, ON, Canada.
  • Kutsogiannis D; University Hospital of North Norway, Tromsø, Norway.
  • Lamontagne F; The University of Alberta, School of Medicine and Dentistry, Edmonton, AB, Canada.
  • Lee TC; Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.
  • Bassi GL; McGill University, Hamilton, ON, Canada.
  • Lopez Revilla JW; University of Queensland, Brisbane, Australia.
  • Marquis C; Instituto Nacional del Niño San Borja, Lima, Peru.
  • Millar J; Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.
  • Neto R; Roslin Institute, University of Edinburgh, Edinburgh, UK.
  • Nichol A; Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
  • Parke R; St Vincent's University Hospital, Dublin, Ireland.
  • Pereira R; Auckland City Hospital, Auckland, New Zealand.
  • Poli S; Hospital Curry Cabral, Lisbon, Portugal.
  • Povoa P; Mount Sinai Medical Center, Miami, FL, USA.
  • Ramanathan K; Hospital São Francisco Xavier, Lisbon, Portugal.
  • Rewa O; National University of Singapore, Singapore, Singapore.
  • Riera J; The University of Alberta, School of Medicine and Dentistry, Edmonton, AB, Canada.
  • Shrapnel S; Vall d'Hebron Institute of Research, Barcelona, Spain.
  • Silva MJ; University of Queensland, Brisbane, Australia.
  • Udy A; Centro Hospitalar Universitário do Porto, Porto, Portugal.
  • Uyeki T; Monash University, Melbourne, Australia.
  • Webb SA; Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
ERJ Open Res ; 8(1)2022 Jan.
Article in English | MEDLINE | ID: covidwho-1690978
ABSTRACT
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.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Year: 2022 Document Type: Article Affiliation country: 23120541.00552-2021

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Year: 2022 Document Type: Article Affiliation country: 23120541.00552-2021