Near real-time observation reveals increased prevalence of young patients in the ICU during the emerging third SARS-CoV-2 wave in Switzerland
AIMS OF THE STUDY During the ongoing COVID-19 pandemic, the launch of a large-scale vaccination campaign and virus mutations have hinted at possible changes in transmissibility and the virulence affecting disease progression up to critical illness, and carry potential for future vaccinat...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2021-07-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/3035 |
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| author | Matthias P. Hilty André Moser Sascha David Pedro D. Wendel-Garcia Giuliana Capaldo Stefanie Keiser Thierry Fumeaux Philippe Guerci Jonathan Montomoli Thomas P. Van Boeckel Marie-Madlen Jeitziner Yok-Ai Que Stephan Jakob Reto A. Schuepbach RISC-19-ICU Investigators for Switzerland |
| author_facet | Matthias P. Hilty André Moser Sascha David Pedro D. Wendel-Garcia Giuliana Capaldo Stefanie Keiser Thierry Fumeaux Philippe Guerci Jonathan Montomoli Thomas P. Van Boeckel Marie-Madlen Jeitziner Yok-Ai Que Stephan Jakob Reto A. Schuepbach RISC-19-ICU Investigators for Switzerland |
| author_sort | Matthias P. Hilty |
| collection | DOAJ |
| description |
AIMS OF THE STUDY
During the ongoing COVID-19 pandemic, the launch of a large-scale vaccination campaign and virus mutations have hinted at possible changes in transmissibility and the virulence affecting disease progression up to critical illness, and carry potential for future vaccination failure. To monitor disease development over time with respect to critically ill COVID-19 patients, we report near real-time prospective observational data from the RISC-19-ICU registry that indicate changed characteristics of critically ill patients admitted to Swiss intensive care units (ICUs) at the onset of a third pandemic wave.
METHODS
1829 of 3344 critically ill COVID-19 patients enrolled in the international RISC-19-ICU registry as of 31 May 2021 were treated in Switzerland and were included in the present study. Of these, 1690 patients were admitted to the ICU before 1 February 2021 and were compared with 139 patients admitted during the emerging third pandemic wave
RESULTS
Third wave patients were a mean of 5.2 years (95% confidence interval [CI] 3.2–7.1) younger (median 66.0 years, interquartile range [IQR] 57.0–73.0 vs 62.0 years, IQR 54.5–68.0; p <0.0001) and had a higher body mass index than patients admitted in the previous pandemic period. They presented with lower SAPS II and APACHE II scores, less need for circulatory support and lower white blood cell counts at ICU admission. P/F ratio was similar, but a 14% increase in ventilatory ratio was observed over time (p = 0.03)
CONCLUSION
Near real-time registry data show that the latest COVID-19 patients admitted to ICUs in Switzerland at the onset of the third wave were on average 5 years younger, had a higher body mass index, and presented with lower physiological risk scores but a trend towards more severe lung failure. These differences may primarily be related to the ongoing nationwide vaccination campaign, but the possibility that changes in virus-host interactions may be a co-factor in the age shift and change in disease characteristics is cause for concern, and should be taken into account in the public health and vaccination strategy during the ongoing pandemic. (ClinicalTrials.gov Identifier: NCT04357275)
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| first_indexed | 2024-04-11T04:27:01Z |
| format | Article |
| id | doaj.art-6a903093737b4937bc91fbed7f023ef1 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2025-02-18T09:49:53Z |
| publishDate | 2021-07-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-6a903093737b4937bc91fbed7f023ef12024-11-02T11:59:24ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972021-07-01151293010.4414/smw.2021.20553Near real-time observation reveals increased prevalence of young patients in the ICU during the emerging third SARS-CoV-2 wave in SwitzerlandMatthias P. Hilty0André Moser1Sascha David2Pedro D. Wendel-Garcia3Giuliana Capaldo4Stefanie Keiser5Thierry Fumeaux6Philippe Guerci7Jonathan Montomoli8Thomas P. Van Boeckel9Marie-Madlen Jeitziner10Yok-Ai Que11Stephan Jakob12Reto A. Schuepbach13RISC-19-ICU Investigators for SwitzerlandInstitute of Intensive Care Medicine, University Hospital of Zurich, SwitzerlandCTU Bern, University of Bern, SwitzerlandInstitute of Intensive Care Medicine, University Hospital of Zurich, SwitzerlandInstitute of Intensive Care Medicine, University Hospital of Zurich, SwitzerlandInstitute of Intensive Care Medicine, University Hospital of Zurich, SwitzerlandInstitute of Intensive Care Medicine, University Hospital of Zurich, SwitzerlandSwiss Society of Intensive Care Medicine, Basel, SwitzerlandDepartment of Anaesthesiology and Critical Care Medicine, University Hospital of Nancy, FranceDepartment of Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, NetherlandsHealth Geography and Policy Group, ETH Zürich, SwitzerlandDepartment of Intensive Care Medicine, Bern University Hospital, University of Bern, SwitzerlandDepartment of Intensive Care Medicine, Bern University Hospital, University of Bern, SwitzerlandDepartment of Intensive Care Medicine, Bern University Hospital, University of Bern, SwitzerlandInstitute of Intensive Care Medicine, University Hospital of Zurich, Switzerland AIMS OF THE STUDY During the ongoing COVID-19 pandemic, the launch of a large-scale vaccination campaign and virus mutations have hinted at possible changes in transmissibility and the virulence affecting disease progression up to critical illness, and carry potential for future vaccination failure. To monitor disease development over time with respect to critically ill COVID-19 patients, we report near real-time prospective observational data from the RISC-19-ICU registry that indicate changed characteristics of critically ill patients admitted to Swiss intensive care units (ICUs) at the onset of a third pandemic wave. METHODS 1829 of 3344 critically ill COVID-19 patients enrolled in the international RISC-19-ICU registry as of 31 May 2021 were treated in Switzerland and were included in the present study. Of these, 1690 patients were admitted to the ICU before 1 February 2021 and were compared with 139 patients admitted during the emerging third pandemic wave RESULTS Third wave patients were a mean of 5.2 years (95% confidence interval [CI] 3.2–7.1) younger (median 66.0 years, interquartile range [IQR] 57.0–73.0 vs 62.0 years, IQR 54.5–68.0; p <0.0001) and had a higher body mass index than patients admitted in the previous pandemic period. They presented with lower SAPS II and APACHE II scores, less need for circulatory support and lower white blood cell counts at ICU admission. P/F ratio was similar, but a 14% increase in ventilatory ratio was observed over time (p = 0.03) CONCLUSION Near real-time registry data show that the latest COVID-19 patients admitted to ICUs in Switzerland at the onset of the third wave were on average 5 years younger, had a higher body mass index, and presented with lower physiological risk scores but a trend towards more severe lung failure. These differences may primarily be related to the ongoing nationwide vaccination campaign, but the possibility that changes in virus-host interactions may be a co-factor in the age shift and change in disease characteristics is cause for concern, and should be taken into account in the public health and vaccination strategy during the ongoing pandemic. (ClinicalTrials.gov Identifier: NCT04357275) https://www.smw.ch/index.php/smw/article/view/3035COVID-19SARS-CoV-2critical illnessARDSpandemicEpidemiology |
| spellingShingle | Matthias P. Hilty André Moser Sascha David Pedro D. Wendel-Garcia Giuliana Capaldo Stefanie Keiser Thierry Fumeaux Philippe Guerci Jonathan Montomoli Thomas P. Van Boeckel Marie-Madlen Jeitziner Yok-Ai Que Stephan Jakob Reto A. Schuepbach RISC-19-ICU Investigators for Switzerland Near real-time observation reveals increased prevalence of young patients in the ICU during the emerging third SARS-CoV-2 wave in Switzerland Swiss Medical Weekly COVID-19 SARS-CoV-2 critical illness ARDS pandemic Epidemiology |
| title | Near real-time observation reveals increased prevalence of young patients in the ICU during the emerging third SARS-CoV-2 wave in Switzerland |
| title_full | Near real-time observation reveals increased prevalence of young patients in the ICU during the emerging third SARS-CoV-2 wave in Switzerland |
| title_fullStr | Near real-time observation reveals increased prevalence of young patients in the ICU during the emerging third SARS-CoV-2 wave in Switzerland |
| title_full_unstemmed | Near real-time observation reveals increased prevalence of young patients in the ICU during the emerging third SARS-CoV-2 wave in Switzerland |
| title_short | Near real-time observation reveals increased prevalence of young patients in the ICU during the emerging third SARS-CoV-2 wave in Switzerland |
| title_sort | near real time observation reveals increased prevalence of young patients in the icu during the emerging third sars cov 2 wave in switzerland |
| topic | COVID-19 SARS-CoV-2 critical illness ARDS pandemic Epidemiology |
| url | https://www.smw.ch/index.php/smw/article/view/3035 |
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