@article{Reyes_L-2022_63802,
title = {Clinical characteristics, risk factors and outcomes in patients with severe COVID-19 registered in the ISARIC WHO Clinical Characterisation Protocol: A prospective, multinational, multicentre, observational study},
author = {Reyes, L. and Murthy, S. and Garcia-Gallo, E. and Irvine, M. and Merson, L. and Martin-Loeches, I. and Rello, J. and Taccone, F. and Fowler, R. and Docherty, A. and Kartsonaki, C. and Aragao, I. and Barrett, P. and Beane, A. and Burrell, A. and Cheng, M. and Christian, M. and Cidade, J. and Citarella, B. and Donnelly, C. and Fernandes, S. and French, C. and Haniffa, R. and Harrison, E. and Ho, A. and Joseph, M. and Khan, I. and Kho, M. and Kildal, A. and Kutsogiannis, D. and Lamontagne, F. and Lee, T. and Bassi, G. and Lopez Revilla, J. and Marquis, C. and Millar, J. and Neto, R. and Nichol, A. and Parke, R. and Pereira, R. and Poli, S. and Povoa, P. and Ramanathan, K. and Rewa, O. and Riera, J. and Shrapnel, S. and Joao Silva, M. and Udy, A. and Uyeki, T. and Webb, S. and Wils, E. and Rojek, A. and Olliaro, P.},
month = {jan},
year = {2022},
abstract = {Due to the large number of patients with severe COVID-19, many were treated outside of the traditional walls of the 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 of the ICU is unknown. This was a multinational, multicentre, prospective cohort study embedded in the ISARIC WHO 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 non-invasive mechanical ventilation, high-flow nasal cannula, inotropes, and vasopressors. A logistic Generalised Additive Model was used to compare clinical outcomes among patients admitted and 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 [IQR], 67 years [55, 78]), and with at least one comorbidity (63.2%). The overall median (IQR) length of hospital stay was 10 days (5–19) and was longer in patients admitted to an ICU than in those that were cared for outside of ICU (12 [6–23] versus 8 [4–15] days, p&lt;0.0001). The 28-day fatality ratio was lower in ICU-admitted patients (30.7% [5797/18831] versus 39.0% [7532/19295], p&lt;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&lt;0.0001). Patients with severe COVID-19 admitted to an ICU had significantly lower 28-day fatality ratio than those cared for outside of an ICU.},
volume = {8},
issue = {1},
journal = {ERJ Open Research},
publisher = {European Respiratory Society and ISARIC Clinical Characterization Group},
url = {http://dx.doi.org/10.1183/23120541.00552-2021},
}
