دورية أكاديمية
Clinical characteristics and factors associated with ICU mortality during the first year of the SARS-Cov-2 pandemic in Romania: A prospective, cohort, multicentre study of 9000 patients.
| العنوان: | Clinical characteristics and factors associated with ICU mortality during the first year of the SARS-Cov-2 pandemic in Romania: A prospective, cohort, multicentre study of 9000 patients. |
|---|---|
| المؤلفون: | Bubenek-Turconi ŞI; From the Anesthesiology and Intensive Care Department, Carol Davila University of Medicine and Pharmacy (Ş-IB-T, SA, DT, MP, DF, BM), Cardiac Anesthesiology and Intensive Care Department I, Emergency Institute for Cardiovascular Diseases Prof. Dr C. C. Iliescu, Bucharest, Romania (Ş-IB-T, LV, CB, BM), Anaesthesiology and Critical Care Department, Dijon Bourgogne University Hospital, Dijon, France (SA), Cardiac Anesthesiology and Intensive Care Department II, Emergency Institute for Cardiovascular Diseases Prof. Dr C. C. Iliescu, Bucharest, Romania (M-GŞ, DF), Anaesthesiology and Intensive Care Department, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania (IG), Anaesthesiology and Intensive Care Department, Regional Institute of Oncology, Iaşi, Romania (IG), Anaesthesiology and Intensive Care Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, Târgu Mureş, Romania (SC), Anaesthesiology and Intensive Care Department II, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca (CB), Anaesthesiology and Intensive Care Department III, Fundeni Clinical Institute (DT, MP), Department of Cardiovascular Surgery, Clinical Emergency Hospital Bucharest, 014461, Bucharest, Romania; Department of Cardiovascular Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (HM), Anaesthesiology and Intensive Care Department, Emergency County Hospital Pius Brinzeu (FR, DS), Anaesthesiology and Intensive Care Department, Victor Babeş University of Medicine and Pharmacy, Timişoara (FR, DS) and Department for Emergency Situations, Ministry of Internal Affairs, Bucharest, Romania (RA)., Andrei S, Văleanu L, Ştefan MG, Grigoraş I, Copotoiu S, Bodolea C, Tomescu D, Popescu M, Filipescu D, Moldovan H, Rogobete AF, Bălan C, Moroşanu B, Săndesc D, Arafat R |
| مؤلفون مشاركون: | COVATI-RO Collaborative |
| المصدر: | European journal of anaesthesiology [Eur J Anaesthesiol] 2023 Jan 01; Vol. 40 (1), pp. 4-12. Date of Electronic Publication: 2022 Nov 16. |
| نوع المنشور: | Observational Study; Multicenter Study; Journal Article; Comment |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins, 2009- Country of Publication: England NLM ID: 8411711 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2346 (Electronic) Linking ISSN: 02650215 NLM ISO Abbreviation: Eur J Anaesthesiol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Cambridge : Lippincott Williams & Wilkins, 2009- Original Publication: Oxford ; Boston : Published on behalf of the European Academy of Anaesthesiology by Blackwell Scientific, 1984-2004 |
| مواضيع طبية MeSH: | Diabetes Mellitus, Type 2* , COVID-19*, Humans ; Male ; SARS-CoV-2 ; Prospective Studies |
| مستخلص: | Background: The epidemiology of critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be different worldwide. Despite similarities in medicine quality and formation, there are also significant differences concerning healthcare and ICU organisation, staffing, financial resources and population compliance and adherence. Large cohort data of critically ill patients from Central and Eastern Europe are also lacking. Objectives: The study objectives were to describe the clinical characteristics of patients admitted to Romanian ICUs with SARS-CoV-2 infection and to identify the factors associated with ICU mortality. Design: Prospective, cohort, observational study. Setting: National recruitment, multicentre study, between March 2020 to March 2021. Patients: All patients with SARS-CoV-2 infection admitted to Romanian ICUs were eligible. There were no exclusion criteria. Intervention: None. Main Outcome Measure: ICU mortality. Results: The statistical analysis included 9058 patients with definitive ICU outcome. The multivariable mixed effects logistic regression model found that age [odds ratio (OR) 1.27; 95% confidence interval (CI), 1.23 to 1.31], male gender (OR 1.21; 95% CI 1.05 to 1.4), medical history of neoplasia (OR 1.74; 95% CI, 1.36 to 2.22), chronic kidney disease (OR 1.54; 95% CI, 1.27 to 1.88), type II diabetes (OR 1.23; 95% CI, 1.06 to 1.43), chronic heart failure (OR 1.24; 95% CI, 1.03 to 1.49), dyspnoea (OR 1.3; 95% CI, 1.1 to 1.5), SpO2 less than 90% (OR 3; 95% CI, 2.5 to 3.5), admission SOFA score (OR 1.07; 95% CI, 1.05 to 1.09), acute respiratory distress syndrome (ARDS) on ICU admission (OR 1.35; 95% CI, 1.1 to 1.63) and the need for noninvasive (OR 1.8, 95% CI, 1.5 to 1.22) or invasive ventilation (OR 28; 95% CI, 22 to 35) and neuromuscular blockade (OR 3.5; 95% CI, 2.6 to 4.8), were associated with larger ICU mortality.Higher GCS on admission (OR 0.81; 95% CI, 0.79 to 0.83), treatment with hydroxychloroquine (OR 0.78; 95% CI, 0.64 to 0.95) and tocilizumab (OR 0.58; 95% CI, 0.48 to 0.71) were inversely associated with ICU mortality. Conclusion: The SARS-CoV-2 critically ill Romanian patients share common personal and clinical characteristics with published European cohorts. Public health measures and vaccination campaign should focus on patients at risk. (Copyright © 2022 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.) |
| التعليقات: | Comment on: BMJ Glob Health. 2021 Sep;6(9):. (PMID: 34518205) |
| References: | Fauci AS, Lane HC, Redfield RR. Covid-19 — navigating the uncharted. N Engl J Med 2020; 382:1268–1269. Chakraborty I, Maity P. COVID-19 outbreak: migration, effects on society, global environment and prevention. Sci Total Environ 2020; 728:138882. The Lancet. India under COVID-19 lockdown. The Lancet 2020; 395:1315. COVID-ICU Group on behalf of the REVA Network and the COVID-ICU Investigators. Clinical characteristics and day-90 outcomes of 4244 critically ill adults with COVID-19: a prospective cohort study. Intensive Care Med 2021; 47:60–73. Jung CY, Park H, Kim DW, et al. Clinical characteristics of asymptomatic patients with COVID-19: a nationwide cohort study in South Korea. Int J Infect Dis 2020; 99:266–268. Rosenthal N, Cao Z, Gundrum J, et al. Risk factors associated with in-hospital mortality in a US national sample of patients with COVID-19. JAMA Netw Open 2020; 3:e2029058. Alaa A, Qian Z, Rashbass J, et al. Retrospective cohort study of admission timing and mortality following COVID-19 infection in England. BMJ Open 2020; 10:e042712. Chew MS, Blixt PJ, Åhman R, et al. National outcomes and characteristics of patients admitted to Swedish intensive care units for COVID-19: a registry-based cohort study. Eur J Anaesthesiol 2021; 38:335–343. Chen YH, Fang CT. Mortality from COVID-19: a cross-country comparison of containment versus mitigation strategy. J Formosan Med Assoc 2020; 119:1710–1712. Ludvigsson JF. The first eight months of Sweden's COVID-19 strategy and the key actions and actors that were involved. Acta Paediatr 2020; 109:2459–2471. Oroszi B, Juhász A, Nagy C, et al. Unequal burden of COVID-19 in Hungary: a geographical and socioeconomic analysis of the second wave of the pandemic. BMJ Glob Health 2021; 6:e006427. Mitre C, Breazu C, Mitre I, et al. Migration of skilled anaesthesiologists from low to high-income economies: urgent action needed. Eur J Anaesthesiol 2016; 33:157–159. Marijanović I, Kraljević M, Buhovac T, et al. Acceptance of COVID-19 vaccination and its associated factors among cancer patients attending the oncology clinic of university clinical hospital Mostar, Bosnia and Herzegovina: a cross-sectional study. Med Sci Monit 2021; 27:e932788. Ryazantsev SV, Khramova MN, Smirnov AV. The social demographic aspects of vaccination of population of Russia in the context of COVID-19 pandemic. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2021; 29:1047–1056. Jilich D, Skrzat-Klapaczyńska A, Fleischhans L, et al. National strategies for vaccination against COVID-19 in people living with HIV in Central and Eastern European region. HIV Med 2021. Ordinul nr. 487/2020 pentru aprobarea protocolului de tratament al infecției cu virusul SARS-Cov-2 [Internet]. 2020. Available at: http://www.cnscbt.ro/index.php/lex/1591-ordinul-nr-487-2020-pentru-aprobarea-protocolului-de-tratament-covid/file. Actualizare zilnică (31/03) - evidența persoanelor vaccinate împotriva COVID-19 [Internet]. Available at: https://vaccinare-covid.gov.ro/wp-content/uploads/2021/03/Tabel-situatie-vaccinari_31.03.2021.pdf . Churpek MM, Gupta S, Spicer AB, et al. Hospital-level variation in death for critically ill patients with COVID-19. Am J Respir Crit Care Med 2021; 204:403–411. Grasselli G, Greco M, Zanella A, et al. Risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA Intern Med 2020; 180:1345. Popadic V, Klasnja S, Milic N, et al. Predictors of mortality in critically Ill COVID-19 patients demanding high oxygen flow: a thin line between inflammation, cytokine storm, and coagulopathy. Oxid Med Cell Longev 2021; 2021:6648199. Taylor EH, Marson EJ, Elhadi M, et al. Factors associated with mortality in patients with COVID-19 admitted to intensive care: a systematic review and meta-analysis. Anaesthesia 2021; 76:1224–1232. Izcovich A, Ragusa MA, Tortosa F, et al. Prognostic factors for severity and mortality in patients infected with COVID-19: a systematic review. PLoS One 2020; 15:e0241955. Ramos-Rincon JM, Buonaiuto V, Ricci M, et al. Clinical characteristics and risk factors for mortality in very old patients hospitalized with COVID-19 in Spain. J Gerontol 2021; 76:e28–e37. Li J, He X, Yuan Y, et al. Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. Am J Infect Control 2021; 49:82–89. Andrei S, Valeanu L, Stefan MG, et al. Outcomes of COVID-19 critically ill extremely elderly patients: analysis of a large, national, observational cohort. JCM 2022; 11:1544. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York city area. JAMA 2020; 323:2052. Chang R, Elhusseiny KM, Yeh YC, et al. COVID-19 ICU and mechanical ventilation patient characteristics and outcomes—a systematic review and meta-analysis. PLoS One 2021; 16:e0246318. Tleyjeh IM, Kashour Z, Riaz M, et al. Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis, first update. Clin Microbiol Infect 2021; 27:1076–1082. Prats-Uribe A, Sena AG, Lai LYH, et al. Use of repurposed and adjuvant drugs in hospital patients with covid-19: multinational network cohort study. BMJ 2021; n1038. Taccone FS, Van Goethem N, De Pauw R, et al. The role of organizational characteristics on the outcome of COVID-19 patients admitted to the ICU in Belgium. Lancet Regional Health - Europe 2021; 2:100019. Sterne JAC, Murthy S, et al. The WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group. Association between administration of systemic corticosteroids and mortality among critically ill patients with COVID-19: a meta-analysis. JAMA 2020; 324:1330. Hasan SS, Kow CS, Mustafa ZU, et al. Does methylprednisolone reduce the mortality risk in hospitalized COVID-19 patients? A meta-analysis of randomized control trials. Expert Rev Respir Med 2021; 15:1049–1055. Abbas M, Abbass H, et al. RECOVERY Collaborative Group. Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet 2021; 397:1637–1645. Blonz G, Kouatchet A, Chudeau N, et al. Epidemiology and microbiology of ventilator-associated pneumonia in COVID-19 patients: a multicenter retrospective study in 188 patients in an un-inundated French region. Crit Care 2021; 25:72. Roelens M, Martin A, Friker B, et al. Evolution of COVID-19 mortality over time: results from the Swiss hospital surveillance system (CH-SUR). Swiss Med Wkly 2021; 151:w30105. Popescu M, Ştefan OM, Ştefan M, et al. ICU-associated costs during the fourth wave of the COVID-19 pandemic in a tertiary hospital in a low-vaccinated Eastern European Country. IJERPH 2022; 19:1781. |
| تواريخ الأحداث: | Date Created: 20221117 Date Completed: 20221215 Latest Revision: 20230203 |
| رمز التحديث: | 20230203 |
| DOI: | 10.1097/EJA.0000000000001776 |
| PMID: | 36385096 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder كن أول من يترك تعليقا!