Your browser doesn't support javascript.
Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study.
Greco, Massimiliano; De Corte, Thomas; Ercole, Ari; Antonelli, Massimo; Azoulay, Elie; Citerio, Giuseppe; Morris, Andy Conway; De Pascale, Gennaro; Duska, Frantisek; Elbers, Paul; Einav, Sharon; Forni, Lui; Galarza, Laura; Girbes, Armand R J; Grasselli, Giacomo; Gusarov, Vitaly; Jubb, Alasdair; Kesecioglu, Jozef; Lavinio, Andrea; Delgado, Maria Cruz Martin; Mellinghoff, Johannes; Myatra, Sheila Nainan; Ostermann, Marlies; Pellegrini, Mariangela; Povoa, Pedro; Schaller, Stefan J; Teboul, Jean-Louis; Wong, Adrian; De Waele, Jan J; Cecconi, Maurizio.
  • Greco M; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.
  • De Corte T; IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy.
  • Ercole A; Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
  • Antonelli M; Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium.
  • Azoulay E; Cambridge Centre for Artificial Intelligence in Medicine, University of Cambridge, Cambridge, UK.
  • Citerio G; University of Cambridge Division of Anaesthesia, Addenbrooke's Hospital, Hills Road, Cambridge, UK.
  • Morris AC; Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy.
  • De Pascale G; Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Rome, Italy.
  • Duska F; Médecine Intensive et Réanimation, APHP, Saint-Louis Hospital, Paris University, Paris, France.
  • Elbers P; Université de Paris, Paris, France.
  • Einav S; School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
  • Forni L; Department Neuroscience, Neurointensive Care, ASST-Monza, Monza, Italy.
  • Galarza L; Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, UK.
  • Girbes ARJ; Division of Immunology, Department of Pathology, University of Cambridge, Cambridge, UK.
  • Grasselli G; JVF Intensive Care Unit, Addenbrookes Hospital, Cambridge, UK.
  • Gusarov V; Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy.
  • Jubb A; Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Rome, Italy.
  • Kesecioglu J; Department of Anaesthesia and Intensive Care, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
  • Lavinio A; FNKV University Hospital in Prague, Prague, Czech Republic.
  • Delgado MCM; Department of Intensive Care Medicine, Laboratory of Critical Care Computational Intelligence, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
  • Mellinghoff J; General Intensive Care Unit of the Shaare Zedek Medical Center, Jerusalem, Israel.
  • Myatra SN; Faculty of Medicine, Hebrew University, Jerusalem, Israel.
  • Ostermann M; Department of Critical Care, Royal Surrey Hospital and Faculty of Experimental Medicine, University of Surrey, Guildford, UK.
  • Pellegrini M; Intensive Care Unit, Hospital General Universitario de Castellón, Castellón de la Plana, Spain.
  • Povoa P; Department of Intensive Care Medicine, Research VUmc Intensive Care (REVIVE), Amsterdam Medical Data Science (AMDS), Amsterdam Cardiovascular Sciences (ACS), Amsterdam Infection and Immunity Institute (AI&II), UMC, Location VUmc, VU Amsterdam, Amsterdam, The Netherlands.
  • Schaller SJ; Department of Anesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Teboul JL; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
  • Wong A; Pirogov National Medical and Surgical Center, Moscow, 105203, Russian Federation.
  • De Waele JJ; Division of Anaesthesia, University of Cambridge Department of Medicine, Cambridge, UK.
  • Cecconi M; Neurosciences and Trauma Critical Care Unit, Cambridge University Hospitals, Cambridge, UK.
Intensive Care Med ; 48(6): 690-705, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1899123
ABSTRACT

PURPOSE:

To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients.

METHODS:

Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020.

RESULTS:

4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units 20%-50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors.

CONCLUSIONS:

ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Kidney Injury / COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: Intensive Care Med Year: 2022 Document Type: Article Affiliation country: S00134-022-06705-1

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Kidney Injury / COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: Intensive Care Med Year: 2022 Document Type: Article Affiliation country: S00134-022-06705-1