Age, sex, and comorbidities predict ICU admission or mortality in cases with SARS-CoV2 infection: a population-based cohort study

Cardoso, Filipe S.; Papoila, Ana Luísa; Machado, Rita Sá; Fidalgo, Pedro

doi:10.1186/s13054-020-03173-1

Cited by 18 publications

(16 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several studies have assessed the short-term outcomes of hospitalized COVID-19 patients [ 13 , 14 , 15 , 16 , 17 , 18 , 19 ], focusing mainly on patients who received ward-based care. Results show that age and comorbidities are associated with severe outcomes in COVID-19 patients [ 20 , 21 ]. However, there is limited data on the long-term effects of COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Six-Month Outcomes in COVID-19 ICU Patients and Their Family Members: A Prospective Cohort Study

et al. 2021

View full text Add to dashboard Cite

Background: The COVID-19 pandemic has resulted in a major influx of intensive care unit (ICU) admissions. Currently, there is limited knowledge on the long-term outcomes of COVID-19 ICU-survivors and the impact on family members. This study aimed to gain an insight into the long-term physical, social and psychological functioning of COVID-19 ICU-survivors and their family members at three- and six-months following ICU discharge. Methods: A single-center, prospective cohort study was conducted among COVID-19 ICU-survivors and their family members. Participants received questionnaires at three and six months after ICU discharge. Physical functioning was evaluated using the MOS Short-Form General Health Survey, Clinical Frailty Scale and spirometry tests. Social functioning was determined using the McMaster Family Assessment Device and return to work. Psychological functioning was assessed using the Hospital Anxiety and Depression Scale. Results: Sixty COVID-19 ICU-survivors and 78 family members participated in this study. Physical functioning was impaired in ICU-survivors as reflected by a score of 33.3 (IQR 16.7–66.7) and 50 (IQR 16.7–83.3) out of 100 at 3- and 6-month follow-ups, respectively. Ninety percent of ICU-survivors reported persistent symptoms after 6 months. Social functioning was impaired since 90% of COVID-19 ICU-survivors had not reached their pre-ICU work level 6 months after ICU-discharge. Psychological functioning was unaffected in COVID-19 ICU-survivors. Family members experienced worse work status in 35% and 34% of cases, including a decrease in work rate among 18.3% and 7.4% of cases at 3- and 6-months post ICU-discharge, respectively. Psychologically, 63% of family members reported ongoing impaired well-being due to the COVID-19-related mandatory physical distance from their relatives. Conclusion: COVID-19 ICU-survivors suffer from a prolonged disease burden, which is prominent in physical and social functioning, work status and persisting symptoms among 90% of patients. Family members reported a reduction in return to work and impaired well-being. Further research is needed to extend the follow-up period and study the effects of standardized rehabilitation in COVID-19 patients and their family members.

show abstract

Section: Introductionmentioning

confidence: 99%

Six-Month Outcomes in COVID-19 ICU Patients and Their Family Members: A Prospective Cohort Study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The HADS contains a seven-item sub-scale for anxiety and a seven-item sub-scale for depression, with a four-point Likert scale for each question. Total scores per subscale range from 0 to 21, with the sums categorized as normal (0-7), mild (8-10), moderate (11)(12)(13)(14) and severe (15)(16)(17)(18)(19)(20)(21). Fear of reinfection was questioned on a scale of 0 ('no fear') to 10 ('high level of fear').…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have assessed the short-term outcomes after hospitalization for COVID-19 patients [ 13,14,15,16,17,18,19 ], mainly focusing on patients who have received ward-based care. Age and comorbidities are associated with severe outcomes in COVID-19 patients [ 20,21 ]. However, there is little knowledge on the outcomes of COVID-19 survivors after ICU-admission.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes in COVID-19 ICU Patients: A Prospective Cohort Study

Veenendaal

Meulen

Onrust

et al. 2021

Preprint

View full text Add to dashboard Cite

BACKGROUNDThe COVID-19 pandemic causes high rates of intensive care unit (ICU) admissions. After ICU-discharge patients and family members can suffer from persisting impairments known as ‘Post Intensive Care Syndrome’ (PICS) and PICS-family. Since COVID-19 is relatively new, there is barely any knowledge on the long-term outcomes of COVID-19 ICU-survivors and their family members.OBJECTIVESThis study aims to gain insight in the long-term physical, social and psychological functioning of COVID-19 ICU-survivors and their family members at three- and six-months following ICU discharge.METHODSA single-center, prospective cohort study was conducted in COVID-19 ICU-survivors and their family members. Enrolled participants received questionnaires at three and six months after ICU discharge. The MOS Short-Form General Health Survey, Clinical Frailty Scale, spirometry tests, McMaster Family Assessment Device (FAD-GF6+), the Hospital Anxiety and Depression Scale and return to work were used to evaluate physical, social and psychological functioning.RESULTSSixty COVID-19 ICU-survivors and 78 family members participated. Physical functioning was impaired in ICU-survivors as reflected by a score of 33.3 (IQR 16.7-66.7) and 50 (IQR 16.7-83.3) on the physical functioning subscale at 3- and 6-months follow-up respectively. Diffusion lung capacity was reduced in 69% of patients. Ninety percent of the ICU-survivors reported persistent symptoms after 6 months. Social functioning was impaired as 90% of the COVID-19 ICU-survivors did not reach their pre-ICU employment level, 6 months after ICU-discharge. Psychological functioning in ICU-survivors was normal. Family members experienced worse employment status in 35% and 34% including a decrease in employment rate of 18.3% and 7.4% at 3- and 6-months post ICU-discharge, respectively. Psychologically, 63% of the family members reported ongoing impaired well-being due to the COVID-19 related mandatory physical distance to their relatives.CONCLUSIONWe have shown that COVID-19 ICU-survivors suffer from a prolonged burden of disease, prominent in physical- and social functioning, worse employment status and persisting symptoms in 90%. In addition, family members also report long term effects expressed by a reduction in return to work and impaired well-being. Further research needs to extend the follow up and to study the effects of standardized rehabilitation in COVID-19 patients and their family members.

show abstract

“…While the use of clinical frailty in COVID-19 triage has been defended 10 , there are other factors that are relevant to decisions about the benefit and appropriateness of intensive care. Co-morbidity has been clearly linked to mortality in patients with COVID-19, and is a risk factor for length of stay in intensive care 26,27 . Age also appears to be an independent risk factor for intensive care outcome 26,27 .…”

Section: Predictor Of Mortality Likelihood Ratio Test From Logistic Regressionmentioning

confidence: 99%

“…Co-morbidity has been clearly linked to mortality in patients with COVID-19, and is a risk factor for length of stay in intensive care 26,27 . Age also appears to be an independent risk factor for intensive care outcome 26,27 . Younger patients who are clinically frail also have increased intensive care mortality.…”

Section: Predictor Of Mortality Likelihood Ratio Test From Logistic Regressionmentioning

confidence: 99%

Evaluation of a hypothetical decision-support tool for intensive care triage of patients with coronavirus disease 2019 (COVID-19)

et al. 2021

View full text Add to dashboard Cite

Background: At the start of the coronavirus disease 2019 (COVID-19) pandemic there was widespread concern about potentially overwhelming demand for intensive care and the need for intensive care unit (ICU) triage. In March 2020, a draft United Kingdom (UK) guideline proposed a decision-support tool (DST). We sought to evaluate the accuracy of the tool in patients with COVID-19. Methods: We retrospectively identified patients in two groups: referred and not referred to intensive care in a single UK national health service (NHS) trust in April 2020. Age, Clinical Frailty Scale score (CFS), and co-morbidities were collected from patients’ records and recorded, along with ceilings of treatment and outcome. We compared the DST, CFS, and age alone as predictors of mortality, and treatment ceiling decisions. Results: In total, 151 patients were included in the analysis, with 75 in the ICU and 76 in the non-ICU-reviewed groups. Age, clinical frailty and DST score were each associated with increased mortality and higher likelihood of treatment limitation (p-values all <.001). A DST cut-off score of >8 had 65% (95% confidence interval (CI) 51%-79%) sensitivity and 63% (95% CI 54%-72%) specificity for predicting mortality. It had a sensitivity of 80% (70%-88%) and specificity of 96% (95% CI 90%-100%) for predicting treatment limitation. The DST was more discriminative than age alone (p<0.001), and potentially more discriminative than CFS (p=0.08) for predicting treatment ceiling decisions. Conclusions: During the first wave of the COVID-19 pandemic, in a hospital without severe resource limitations, a hypothetical decision support tool was limited in its predictive value for mortality, but appeared to be sensitive and specific for predicting treatment limitation.

show abstract

Age, sex, and comorbidities predict ICU admission or mortality in cases with SARS-CoV2 infection: a population-based cohort study

Cited by 18 publications

References 6 publications

Six-Month Outcomes in COVID-19 ICU Patients and Their Family Members: A Prospective Cohort Study

Six-Month Outcomes in COVID-19 ICU Patients and Their Family Members: A Prospective Cohort Study

Long-Term Outcomes in COVID-19 ICU Patients: A Prospective Cohort Study

Evaluation of a hypothetical decision-support tool for intensive care triage of patients with coronavirus disease 2019 (COVID-19)

Contact Info

Product

Resources

About