Publications

Authors:

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; Donadello, Katia; Gottin, Leonardo; Nizzero, Marta; Polati, Enrico

Title:

Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study

Year:

2022

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

No

Name of journal:

Intensive Care Medicine

ISSN of journal:

0342-4642

N° Volume:

48

Number or Folder:

6

Page numbers:

690-705

Keyword:

COVID-19; Critical care; Pneumonia; SARS-CoV-2; Surge capacity

Short description of contents:

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.

Product ID:

132073

Handle IRIS:

11562/1085589

Last Modified:

February 23, 2023

Bibliographic citation:

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; Donadello, Katia; Gottin, Leonardo; Nizzero, Marta; Polati, Enrico, Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study «Intensive Care Medicine» , vol. 48 , n. 6 , 2022 , pp. 690-705

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