Dynamics of disease characteristics and clinical management of critically ill COVID-19 patients over the time course of the pandemic: an analysis of the prospective, international, multicentre RISC-19-ICU registry.
| Autor: | Wendel-Garcia PD; Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland.; The RISC-19-ICU Registry Board, University of Zurich, Zurich, Switzerland., Moser A; Clinical Trials Unit Bern, University of Bern, Bern, Switzerland., Jeitziner MM; Department of Intensive Care Medicine, University Hospital Bern, Bern, Switzerland., Aguirre-Bermeo H; Unidad de Cuidados Intensivos, Hospital Vicente Corral Moscoso, Cuenca, Ecuador., Arias-Sanchez P; Unidad de Cuidados Intensivos, Hospital Vicente Corral Moscoso, Cuenca, Ecuador., Apolo J; Unidad de Cuidados Intensivos, Hospital Vicente Corral Moscoso, Cuenca, Ecuador., Roche-Campo F; Intensive Care Department, Hospital Verge de La Cinta de Tortosa, Tarragona, Spain., Franch-Llasat D; Intensive Care Department, Hospital Verge de La Cinta de Tortosa, Tarragona, Spain., Kleger GR; Medizinische Intensivstation, Kantonsspital St. Gallen, St. Gallen, Switzerland., Schrag C; Medizinische Intensivstation, Kantonsspital St. Gallen, St. Gallen, Switzerland., Pietsch U; Departement of Anesthesiology and Intensive Care Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland., Filipovic M; Departement of Anesthesiology and Intensive Care Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland., David S; Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland.; Medical Intensive Care, Medical School Hannover, Hannover, Germany., Stahl K; Medical Intensive Care, Medical School Hannover, Hannover, Germany., Bouaoud S; Department of Internal Medicine, Centre Hospitalo Universitaire - Saadna Mohamed Abdnour, Setif, Algeria., Ouyahia A; Department of Internal Medicine, Centre Hospitalo Universitaire - Saadna Mohamed Abdnour, Setif, Algeria., Fodor P; Interdisziplinaere Intensivstation, Stadtspital Zurich - Triemli, Zurich, Switzerland., Locher P; Interdisziplinaere Intensivstation, Stadtspital Zurich - Triemli, Zurich, Switzerland., Siegemund M; Department Intensivmedizin, Universitaetsspital Basel, Basel, Switzerland., Zellweger N; Department Intensivmedizin, Universitaetsspital Basel, Basel, Switzerland., Cereghetti S; Division of Intensive Care, University Hospitals of Geneva, Geneva, Switzerland., Schott P; Institut Fuer Anesthaesie Und Intensivmedizin, Zuger Kantonsspital AG, Baar, Switzerland., Gangitano G; Department of Emergency Medicine, Ospedale Infermi, Rimini, Italy., Wu MA; Department of Internal Medicine, ASST Fatebenefratelli Sacco - 'Luigi Sacco' Hospital, Milan, Italy., Alfaro-Farias M; Unidad de Cuidados Intensivos, Hospital Nostra Senyora de Meritxell, Escaldes-Engordany, Andorra., Vizmanos-Lamotte G; Unidad de Cuidados Intensivos, Hospital Nostra Senyora de Meritxell, Escaldes-Engordany, Andorra., Ksouri H; Soins Intensifs, Hopital Cantonal de Fribourg, Fribourg, Switzerland., Gehring N; Intensivstation, Kantonsspital Schaffhausen, Schaffhausen, Switzerland., Rezoagli E; Department of Anesthesia and Intensive Care Medicine, Policlinico San Marco - Gruppo Ospedaliero San Donato, Bergamo, Italy.; Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy., Turrini F; Internal Medicine, Azienda Ospedaliera Universitaria di Modena, Modena, Italy., Lozano-Gómez H; Unidad de Cuidados Intensivos, Hospital Clínico Universitario Lozano Blesa, Saragossa, Spain., Carsetti A; Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona, Ancona, Italy.; Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy., Rodríguez-García R; Servicio de Medicina Intensiva, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain., Yuen B; Interdisziplinaere Intensivstation, Spital Buelach, Buelach, Switzerland., Weber AB; Anaesthesie Und Intensivmedizin, Kantonsspital Baselland, Liestal, Switzerland., Castro P; Medical Intensive Care Unit, Hospital Clínic de Barcelona - IDIBAPS University of Barcelona, Barcelona, Spain., Escos-Orta JO; Servicio de Medicina Intensiva, Hospital General San Jorge, Huesca, Spain., Dullenkopf A; Institut Fuer Anaesthesie und Intensivmedizin, Spital Thurgau, Frauenfeld, Switzerland., Martín-Delgado MC; Servicio de Medicina Intensiva, Hospital Universitario de Torrejon, Madrid, Spain., Aslanidis T; Intensive Care Unit, St. Paul General Hospital, Thessaloniki, Greece., Perez MH; Pediatric Intensive Care Unit, University Hospital Lausanne, Lausanne, Switzerland., Hillgaertner F; Intensivmedizin, Kantonsspital Graubuenden, Chur, Switzerland., Ceruti S; Dipartimento Area Critica, Clinica Luganese Moncucco, Lugano, Switzerland., Franchitti Laurent M; Service d'Anesthesiologie, EHNV, Yverdon-les-Bains, Switzerland., Marrel J; Institut Für Anaesthesiologie Intensivmedizin & Rettungsmedizin, See-Spital Horgen & Kilchberg, Horgen, Switzerland., Colombo R; Division of Anesthesia and Intensive Care, ASST Fatebenefratelli Sacco - 'Luigi Sacco' Hospital, Milan, Italy., Laube M; Department Intensive Care Medicine, Spitalzentrum Biel, Biel, Switzerland., Fogagnolo A; Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy., Studhalter M; Intensivmedizin & Intermediate Care, Kantonsspital Olten, Olten, Switzerland., Wengenmayer T; Department of Medicine III - Interdisciplinary Medical Intensive Care, Medical Center University of Freiburg, Freiburg, Germany., Gamberini E; Department of Anesthesia and Intensive Care, Infermi Hospital AUSL - Romagna, Rimini, Italy., Buerkle C; Intensivstation, Spital Grabs, Grabs, Switzerland., Buehler PK; Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland., Keiser S; Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland., Elhadi M; Faculty of Medicine, University of Tripoli, Tripoli, Libya., Montomoli J; The RISC-19-ICU Registry Board, University of Zurich, Zurich, Switzerland.; Department of Anesthesia and Intensive Care, Infermi Hospital AUSL - Romagna, Rimini, Italy., Guerci P; The RISC-19-ICU Registry Board, University of Zurich, Zurich, Switzerland.; Department of Anesthesiology and Critical Care Medicine, University Hospital of Nancy, Nancy, France., Fumeaux T; The RISC-19-ICU Registry Board, University of Zurich, Zurich, Switzerland.; Soins Intensifs, Groupement Hospitalier de L'Ouest Lémanique, Hôpital de Nyon, Nyon, Switzerland., Schuepbach RA; Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland.; The RISC-19-ICU Registry Board, University of Zurich, Zurich, Switzerland., Jakob SM; Department of Intensive Care Medicine, University Hospital Bern, Bern, Switzerland., Que YA; Department of Intensive Care Medicine, University Hospital Bern, Bern, Switzerland., Hilty MP; Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland. matthias.hilty@usz.ch.; The RISC-19-ICU Registry Board, University of Zurich, Zurich, Switzerland. matthias.hilty@usz.ch. |
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| Jazyk: | angličtina |
| Zdroj: | Critical care (London, England) [Crit Care] 2022 Jul 04; Vol. 26 (1), pp. 199. Date of Electronic Publication: 2022 Jul 04. |
| DOI: | 10.1186/s13054-022-04065-2 |
| Abstrakt: | Background: It remains elusive how the characteristics, the course of disease, the clinical management and the outcomes of critically ill COVID-19 patients admitted to intensive care units (ICU) worldwide have changed over the course of the pandemic. Methods: Prospective, observational registry constituted by 90 ICUs across 22 countries worldwide including patients with a laboratory-confirmed, critical presentation of COVID-19 requiring advanced organ support. Hierarchical, generalized linear mixed-effect models accounting for hospital and country variability were employed to analyse the continuous evolution of the studied variables over the pandemic. Results: Four thousand forty-one patients were included from March 2020 to September 2021. Over this period, the age of the admitted patients (62 [95% CI 60-63] years vs 64 [62-66] years, p < 0.001) and the severity of organ dysfunction at ICU admission decreased (Sequential Organ Failure Assessment 8.2 [7.6-9.0] vs 5.8 [5.3-6.4], p < 0.001) and increased, while more female patients (26 [23-29]% vs 41 [35-48]%, p < 0.001) were admitted. The time span between symptom onset and hospitalization as well as ICU admission became longer later in the pandemic (6.7 [6.2-7.2| days vs 9.7 [8.9-10.5] days, p < 0.001). The PaO Conclusion: Characteristics and disease course of critically ill COVID-19 patients have continuously evolved, concomitant to the clinical management, throughout the pandemic leading to a younger, less severely ill ICU population with distinctly different clinical, pulmonary and inflammatory presentations than at the onset of the pandemic. (© 2022. The Author(s).) |
| Databáze: | MEDLINE |
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