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French multicentre observational study on SARS-CoV-2 infections intensive care initial management: the FRENCH CORONA study

AIM: Describing acute respiratory distress syndrome patterns, therapeutics management, and outcomes of ICU COVID-19 patients and indentifying risk factors of 28-day mortality. METHODS: Prospective multicentre, cohort study conducted in 29 French ICUs. Baseline characteristics, comorbidities, adjunct...

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Detalles Bibliográficos
Autores principales: Roger, Claire, Collange, Olivier, Mezzarobba, Myriam, Abou-Arab, Osama, Teule, Lauranne, Garnier, Marc, Hoffmann, Clément, Muller, Laurent, Lefrant, Jean-Yves, Guinot, Pierre Grégoire, Novy, Emmanuel, Abraham, Paul, Clavier, Thomas, Bourenne, Jérémy, Besch, Guillaume, Favier, Laurent, Fiani, Michel, Ouattara, Alexandre, Joannes-Boyau, Olivier, Fischer, Marc-Olivier, Leone, Marc, Ait Tamlihat, Younes, Pottecher, Julien, Cordier, Pierre-Yves, Aussant, Philippe, Moussa, Mouhamed Djahoum, Hautin, Etienne, Bouex, Marine, Julia, Jean-Michel, Cady, Julien, Danguy Des Déserts, Marc, Mayeur, Nicolas, Mura, Thibault, Allaouchiche, Bernard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272066/
https://www.ncbi.nlm.nih.gov/pubmed/34256165
http://dx.doi.org/10.1016/j.accpm.2021.100931
Descripción
Sumario:AIM: Describing acute respiratory distress syndrome patterns, therapeutics management, and outcomes of ICU COVID-19 patients and indentifying risk factors of 28-day mortality. METHODS: Prospective multicentre, cohort study conducted in 29 French ICUs. Baseline characteristics, comorbidities, adjunctive therapies, ventilatory support at ICU admission and survival data were collected. RESULTS: From March to July 2020, 966 patients were enrolled with a median age of 66 (interquartile range 58–73) years and a median SAPS II of 37 (29–48). During the first 24 h of ICU admission, COVID-19 patients received one of the following respiratory supports: mechanical ventilation for 559 (58%), standard oxygen therapy for 228 (24%) and high-flow nasal cannula (HFNC) for 179 (19%) patients. Overall, 721 (75%) patients were mechanically ventilated during their ICU stay. Prone positioning and neuromuscular blocking agents were used in 494 (51%) and 460 (48%) patients, respectively. Bacterial co-infections and ventilator-associated pneumonia were diagnosed in 79 (3%) and 411 (43%) patients, respectively. The overall 28-day mortality was 18%. Age, pre-existing comorbidities, severity of respiratory failure and the absence of antiviral therapy on admission were identified as independent predictors of 28-day outcome. CONCLUSION: Severity of hypoxaemia on admission, older age (> 70 years), cardiovascular and renal comorbidities were associated with worse outcome in COVID-19 patients. Antiviral treatment on admission was identified as a protective factor for 28-day mortality. Ascertaining the outcomes of critically ill COVID-19 patients is crucial to optimise hospital and ICU resources and provide the appropriate intensity level of care.