TY - JOUR
AU - Reyes, Luis Felipe
AU - Murthy, Srinivas
AU - Garcia-Gallo, Esteban
AU - Irvine, Mike
AU - Merson, Laura
AU - Martin-Loeches, Ignacio
AU - Rello, Jordi
AU - Taccone, Fabio S.
AU - Fowler, Robert A.
AU - Docherty, Annemarie B.
AU - Kartsonaki, Christiana
AU - Aragao, Irene
AU - Barrett, Peter W.
AU - Beane, Abigail
AU - Burrell, Aidan
AU - Cheng, Matthew Pellan
AU - Christian, Michael D.
AU - Cidade, Jose Pedro
AU - Citarella, Barbara Wanjiru
AU - Donnelly, Christl A.
AU - Fernandes, Susana
AU - French, Craig
AU - Haniffa, Rashan
AU - Harrison, Ewen M.
AU - Ho, Antonia
AU - Joseph, Mark
AU - Khan, Irfan
AU - Kho, Michelle E.
AU - Kildal, Anders Benjamin
AU - Kutsogiannis, Demetrios
AU - Lamontagne, François
AU - Lee, Todd C.
AU - Bassi, Gianluigi Li 
AU - Lopez Revilla, Jose Wagner
AU - Marquis, Catherine
AU - Millar, Jonathan E.
AU - Neto, Raul
AU - Nichol, Alistair D.
AU - Parke, Rachael
AU - Pereira, Rui
AU - Poli, Sergio
AU - Povoa, Pedro
AU - Ramanathan, Kollengode
AU - Rewa, Oleska
AU - Riera, Jordi
AU - Shrapnel, Sally
AU - Joao Silva, Maria
AU - Udy, Andrew
AU - Uyeki, Timothy
AU - Webb, Steve A.
AU - Wils, Evert-Jan
AU - Rojek, Amanda
AU - Olliaro, Piero L.
PY - 2022
DA - January
TI - 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
JO - ERJ Open Research
VL - 8
IS - 1
DO - http://dx.doi.org/10.1183/23120541.00552-2021
AB - 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.
PB - European Respiratory Society
PB - ISARIC Clinical Characterization Group
UR - http://eprints.gla.ac.uk/258957/
KW - Coronavirus (COVID-19)
ER