Comparison of outcome and characteristics between 6343 COVID-19 patients and 2256 other community-acquired viral pneumonia patients admitted to Dutch ICUs

Brinkman, Sylvia; Termorshuizen, Fabian; Dongelmans, Dave A.; Bakhshi‐Raiez, Ferishta; Arbous, M. Sesmu; Lange, Dylan W. de; Keizer, Nicolette F. de; Velde, L. F. te; Driel, E. M. van; Rijpstra, Tom A.; Elbers, P.; Houwink, Aletta P. I.; Georgieva, L. V.; Verweij, E.; Jong, Robert M. de; Iersel, Freya M. van; Koning, T.J.J.; Rengers, Els; Kuşadasi, Nuray; Erkamp, M. L.; Berg, Roy van den; Jacobs, C.J.M.G.; Epker, Jelle L.; Rijkeboer, A. A.; Bruin, M.T. de; Spronk, Peter E.; Draisma, Annelies; Versluis, Dennis; Berg, A.E. van den; Mos, M. Vrolijk-de; Lens, Judith; Pruijsten, R.V.; Kieft, Hans; Rozendaal, J.; Nooteboom, Fleur G. C. A.; Boer, Dirk P.; Janssen, Inge; Gulik, Laura van; Koetsier, M.; Silderhuis, Vera M.; Schnabel, Ronny M.; Drogt, I.; Ruijter, Wouter de; Bosman, Rob J.; Frenzel, Tim; Urlings‐Strop, Louise C.; Dijkhuizen, A.; Hené, I.Z.; Meijer, Adam; Holtkamp, J; Postma, Nienke L.; Bindels, Alexander J. G. H.; Wesselink, R. M. J.; Slobbe-Bijlsma, E.R. van; Voort, Peter H. J. van der; Eikemans, Bob J.W.; Mehagnoul-Schipper, D.J.; Gommers, D.; Lutisan, Johan; Hoeksema, M.; Barnas, M.G.W.; Festen-Spanjer, Barbara; Lieshout, M. van; Gritters, Niels; Tellingen, Martijn van; Brunnekreef, Gert B.; Vandeputte, Joris; Dormans, Tom; Hoogendoorn, Mark; Graaff, M. de; Moolenaar, D.; Reidinga, A. C.; Spijkstra, Jan Jaap; Waal, R. De

doi:10.1016/j.jcrc.2021.12.007

Cited by 10 publications

(10 citation statements)

References 20 publications

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“…This was calculated as the number of occupied beds at the day of ICU admission at the pertinent ICU as percentage of the daily average in 2019 specific for that ICU. 19,20 T To better understand the differences in characteristics between the different cohorts and their effect on outcome, case-mix adjustments were performed in steps.…”

Section: Discussionmentioning

confidence: 99%

“…Brinkman and colleagues previously analyzed the differences in characteristics and outcomes of COVID-19 patients of all ages compared to patients with other viral pneumonia admitted in a historical time period and demonstrated a prolonged hospital LOS and a significantly higher inhospital mortality rate for the patients with COVID-19. 20 We exclusively included patients ≥70 years old and additionally compared with patients admitted in the same time period. The study of Guidet and colleagues, demonstrated an increased 30-day mortality in patients ≥80 years old admitted to the ICU with COVID-19, compared to patients with respiratory failure without COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“…In additional exploratory analysis the model with adjustment for patient characteristics was extended with adjustment for ICU occupancy rate, by using the occupancy rate at the day of ICU admission. This was calculated as the number of occupied beds at the day of ICU admission at the pertinent ICU as percentage of the daily average in 2019 specific for that ICU 19,20 …”

Section: Methodsmentioning

confidence: 99%

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Increased mortality in ICU patients ≥70 years old with COVID‐19 compared to patients with other pneumonias

Haas

Termorshuizen

Uil

et al. 2023

J American Geriatrics Society

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Background Patients over 70 years old represent a substantial proportion of the COVID‐19 ICU population and their mortality rates are high. The aim of this study is to describe the outcomes of patients ≥70 years old admitted to Dutch ICUs with COVID‐19, compared to patients ≥70 years old admitted to the ICU for bacterial and other viral pneumonias, with adjustments for age, comorbidities, severity of illness, and ICU occupancy rate. Methods Retrospective cohort study including patients ≥70 years old admitted to Dutch ICUs, comparing patients admitted with COVID‐19 from March 1st 2020 to January 1st 2022 with patients ≥70 years old admitted because of a bacterial and other viral pneumonia, both divided in a historical (i.e., January 1st 2017 to January 1st 2020) and current cohort (i.e., March 1st 2020 to January 1st 2022). Primary outcome is hospital mortality. Results 11,525 unique patients ≥70 years old admitted to Dutch ICUs were included; 5094 with COVID‐19, 5334 with a bacterial pneumonia, and 1312 with another viral pneumonia. ICU‐mortality and in‐hospital mortality rates of the patients ≥70 years old admitted with COVID‐19 were 39.7% and 47.6% respectively. ICU‐ and hospital mortality rates of the patients who were admitted in the same or in an historical time period with a bacterial pneumonia or other viral pneumonias were considerably lower (19.5% and 28.6% for patients with a bacterial pneumonia in the historical cohort and 19.1% and 28.8% in the same period, for the patients with other viral pneumonias 20.7% and 28.9%, and 22.7% and 31.8% respectively, all p < 0.001). Differences persisted after correction for several clinical characteristics and ICU occupancy rate. Conclusions In ICU‐patients ≥70 years old, COVID‐19 is more severe compared to bacterial or viral pneumonia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Increased mortality in ICU patients ≥70 years old with COVID‐19 compared to patients with other pneumonias

Haas

Termorshuizen

Uil

et al. 2023

J American Geriatrics Society

View full text Add to dashboard Cite

show abstract

“…Most patients with COVID-19 are asymptomatic or paucisymptomatic initially, but some of them develop both progressive respiratory failure and multiple organ failure 10 , 11 . The mortality rate of COVID-19 is higher than for other viral pneumonias 12 . Although the details are unclear, the increased thrombosis associated with COVID-19 may contribute to its high mortality 13 .…”

Section: Introductionmentioning

confidence: 78%

Plasminogen activator inhibitor 1 is not a major causative factor for exacerbation in a mouse model of SARS-CoV-2 infection

Nakayama

Azegami

Kiso

et al. 2023

Sci Rep

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Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains a global pandemic. Although several vaccines targeting SARS-CoV-2 spike proteins protect against COVID-19 infection, mutations affecting virus transmissibility and immune evasion potential have reduced their efficacy, leading to the need for a more efficient strategy. Available clinical evidence regarding COVID-19 suggests that endothelial dysfunction with thrombosis is a central pathogenesis of progression to systemic disease, in which overexpression of plasminogen activator inhibitor-1 (PAI-1) may be important. Here we developed a novel peptide vaccine against PAI-1 and evaluated its effect on lipopolysaccharide (LPS)-induced sepsis and SARS-CoV-2 infection in mice. Administration of LPS and mouse-adapted SARS-CoV-2 increased serum PAI-1 levels, although the latter showed smaller levels. In an LPS-induced sepsis model, mice immunized with PAI-1 vaccine showed reduced organ damage and microvascular thrombosis and improved survival compared with vehicle-treated mice. In plasma clot lysis assays, vaccination-induced serum IgG antibodies were fibrinolytic. However, in a SARS-CoV-2 infection model, survival and symptom severity (i.e., body weight reduction) did not differ between vaccine- and vehicle-treated groups. These results indicate that although PAI-1 may promote the severity of sepsis by increasing thrombus formation, it might not be a major contributor to COVID-19 exacerbation.

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“…Another limitation to mention is the fact that we only included patients discharged from the hospital to the home, which may not be representative of the whole population of ICU patients in this period. Almost one-third of COVID-19 patients admitted to Dutch ICUs died in the hospital [ 57 ]. The majority of the ICU patients admitted during this study period were transferred to a rehabilitation center or nursing home and received a structured rehabilitation care plan.…”

Section: Discussionmentioning

confidence: 99%

A Quality Improvement Project to Support Post-Intensive Care Unit Patients with COVID-19: Structured Telephone Support

Hoog

Oers

Boerrigter

et al. 2022

IJERPH

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Background: More than 50% of intensive care unit (ICU) survivors suffer from long-lasting physical, psychosocial, and cognitive health impairments, also called “post-intensive care syndrome” (PICS). Intensive care admission during the COVID-19 pandemic was especially uncertain and stressful, both for patients and for their family. An additional risk of developing symptoms of PICS was feared in the absence of structural aftercare for the patient and family shortly after discharge from the hospital. The purpose of this quality improvement study was to identify PICS symptoms and to support post-intensive care patients and families in the transition from the hospital to the home. Therefore, we offered post-ICU patients and families structured telephone support (STS). Methods: This was a quality improvement study during the 2019 COVID-19 pandemic. A project team developed and implemented a tool to structure telephone calls to identify and order symptoms according to the PICS framework and to give individual support based on this information. We supported post-ICU patients diagnosed with COVID-19 pneumonia and their family caregivers within four weeks after hospital discharge. The reported findings were both quantitative and qualitative. Results: Forty-six post-ICU patients received structured telephone support and reported symptoms in at least one of the three domains of the PICS framework. More than half of the patients experienced a loss of strength or condition and fatigue. Cognitive and psychological impairments were reported less frequently. Family caregivers reported fewer impairments concerning fatigue and sleeping problems and expressed a need for a continuity of care. Based on the obtained information, the ICU nurse practitioners were able to check if individual care plans were optimal and clear and, if indicated, initiated disciplines to optimize further follow-up. Conclusions: The implementation of the STS tool gave insight in the impairments of post-ICU patients. Surprisingly, family caregivers expressed fewer impairments. Giving support early after hospital discharge in a structured way may contribute to providing guidance in the individual care plans and treatment of the early symptoms of PICS (-F).

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Comparison of outcome and characteristics between 6343 COVID-19 patients and 2256 other community-acquired viral pneumonia patients admitted to Dutch ICUs

Cited by 10 publications

References 20 publications

Increased mortality in ICU patients ≥70 years old with COVID‐19 compared to patients with other pneumonias

Increased mortality in ICU patients ≥70 years old with COVID‐19 compared to patients with other pneumonias

Plasminogen activator inhibitor 1 is not a major causative factor for exacerbation in a mouse model of SARS-CoV-2 infection

A Quality Improvement Project to Support Post-Intensive Care Unit Patients with COVID-19: Structured Telephone Support

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