Outcomes of COVID-19 Critically Ill Extremely Elderly Patients: Analysis of a Large, National, Observational Cohort
Background. During the COVID-19 pandemic, resource allocation became a major problem in globally overwhelmed ICUs. The main goal of this study was to describe the clinical characteristics of the very elderly patients (aged ≥ 80 years) with COVID-19 admitted in Romanian ICUs. The study objectives wer...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/6/1544 |
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| author | Stefan Andrei Liana Valeanu Mihai Gabriel Stefan Dan Longrois Mihai Popescu Gabriel Stefan Cosmin Balan Raed Arafat Dan Corneci Gabriela Droc Serban-Ion Bubenek-Turconi on behalf of the COVATI-RO Collaborative |
| author_facet | Stefan Andrei Liana Valeanu Mihai Gabriel Stefan Dan Longrois Mihai Popescu Gabriel Stefan Cosmin Balan Raed Arafat Dan Corneci Gabriela Droc Serban-Ion Bubenek-Turconi on behalf of the COVATI-RO Collaborative |
| author_sort | Stefan Andrei |
| collection | DOAJ |
| description | Background. During the COVID-19 pandemic, resource allocation became a major problem in globally overwhelmed ICUs. The main goal of this study was to describe the clinical characteristics of the very elderly patients (aged ≥ 80 years) with COVID-19 admitted in Romanian ICUs. The study objectives were to evaluate and determine the factors associated with ICU mortality. Methods. We designed a national, multicentric, observational platform with prospective enrolment. This study included patients aged ≥ 80 years admitted in Romanian ICUs with SARS-CoV-2 infection from March 2020 to December 2021. Results. We included 1666 patients with a median age of 83 years and 78% ICU mortality. Male sex, dyspnoea, lower Glasgow Coma Scale and lower SpO2 at ICU admission, the need for mechanical ventilation (MV), and corticosteroid use were independently associated with mortality. A total of 886/1666 (53%) elderly patients underwent invasive mechanical ventilation, with a mortality of 97%. The age impact on mortality was confirmed by a 1:1 propensity matching with less elderly ICU patients. Conclusion. In extremely elderly patients with COVID-19 admitted in the ICU, mortality is high, particularly when requiring MV. Therapy should be directed towards the optimization of less invasive ventilatory methods and the use of MV and corticosteroids only in highly selected patients. |
| first_indexed | 2024-03-09T19:37:09Z |
| format | Article |
| id | doaj.art-0944c161ebdb409e821118e8af584a9f |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T19:37:09Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-0944c161ebdb409e821118e8af584a9f2023-11-24T01:47:57ZengMDPI AGJournal of Clinical Medicine2077-03832022-03-01116154410.3390/jcm11061544Outcomes of COVID-19 Critically Ill Extremely Elderly Patients: Analysis of a Large, National, Observational CohortStefan Andrei0Liana Valeanu1Mihai Gabriel Stefan2Dan Longrois3Mihai Popescu4Gabriel Stefan5Cosmin Balan6Raed Arafat7Dan Corneci8Gabriela Droc9Serban-Ion Bubenek-Turconi10on behalf of the COVATI-RO CollaborativeDepartment of Anaesthesiology and Intensive Care, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, RomaniaCardiac Anaesthesiology and Intensive Care Department I, Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, 258 Fundeni Road, 022328 Bucharest, RomaniaCardiac Anaesthesiology and Intensive Care Department II, Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, 258 Fundeni Road, 022328 Bucharest, RomaniaDepartment of Anaesthesiology and Intensive Care, Bichat-Claude Bernard University Hospital, Sorbonne Universités, INSERM UMR 1148, 46 Rue Henri Huchard, 75018 Paris, FranceDepartment of Anaesthesiology and Intensive Care, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, RomaniaNephrology Department, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, RomaniaCardiac Anaesthesiology and Intensive Care Department I, Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, 258 Fundeni Road, 022328 Bucharest, RomaniaDepartment for Emergency Situations, Ministry of Internal Affairs, 1 Revolution Sq., 030167 Bucharest, RomaniaDepartment of Anaesthesiology and Intensive Care, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, RomaniaDepartment of Anaesthesiology and Intensive Care, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, RomaniaDepartment of Anaesthesiology and Intensive Care, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, RomaniaBackground. During the COVID-19 pandemic, resource allocation became a major problem in globally overwhelmed ICUs. The main goal of this study was to describe the clinical characteristics of the very elderly patients (aged ≥ 80 years) with COVID-19 admitted in Romanian ICUs. The study objectives were to evaluate and determine the factors associated with ICU mortality. Methods. We designed a national, multicentric, observational platform with prospective enrolment. This study included patients aged ≥ 80 years admitted in Romanian ICUs with SARS-CoV-2 infection from March 2020 to December 2021. Results. We included 1666 patients with a median age of 83 years and 78% ICU mortality. Male sex, dyspnoea, lower Glasgow Coma Scale and lower SpO2 at ICU admission, the need for mechanical ventilation (MV), and corticosteroid use were independently associated with mortality. A total of 886/1666 (53%) elderly patients underwent invasive mechanical ventilation, with a mortality of 97%. The age impact on mortality was confirmed by a 1:1 propensity matching with less elderly ICU patients. Conclusion. In extremely elderly patients with COVID-19 admitted in the ICU, mortality is high, particularly when requiring MV. Therapy should be directed towards the optimization of less invasive ventilatory methods and the use of MV and corticosteroids only in highly selected patients.https://www.mdpi.com/2077-0383/11/6/1544elderlyICUmechanical ventilationmortalityoutcomesCOVID-19 |
| spellingShingle | Stefan Andrei Liana Valeanu Mihai Gabriel Stefan Dan Longrois Mihai Popescu Gabriel Stefan Cosmin Balan Raed Arafat Dan Corneci Gabriela Droc Serban-Ion Bubenek-Turconi on behalf of the COVATI-RO Collaborative Outcomes of COVID-19 Critically Ill Extremely Elderly Patients: Analysis of a Large, National, Observational Cohort Journal of Clinical Medicine elderly ICU mechanical ventilation mortality outcomes COVID-19 |
| title | Outcomes of COVID-19 Critically Ill Extremely Elderly Patients: Analysis of a Large, National, Observational Cohort |
| title_full | Outcomes of COVID-19 Critically Ill Extremely Elderly Patients: Analysis of a Large, National, Observational Cohort |
| title_fullStr | Outcomes of COVID-19 Critically Ill Extremely Elderly Patients: Analysis of a Large, National, Observational Cohort |
| title_full_unstemmed | Outcomes of COVID-19 Critically Ill Extremely Elderly Patients: Analysis of a Large, National, Observational Cohort |
| title_short | Outcomes of COVID-19 Critically Ill Extremely Elderly Patients: Analysis of a Large, National, Observational Cohort |
| title_sort | outcomes of covid 19 critically ill extremely elderly patients analysis of a large national observational cohort |
| topic | elderly ICU mechanical ventilation mortality outcomes COVID-19 |
| url | https://www.mdpi.com/2077-0383/11/6/1544 |
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