What changed between the peak and plateau periods of the first COVID-19 pandemic wave? A multicentric Portuguese cohort study in intensive care
OBJECTIVE: To analyze and compare COVID-19 patient characteristics, clinical management and outcomes between the peak and plateau periods of the first pandemic wave in Portugal.
METHODS: This was a multicentric ambispective cohort study including consecutive severe COVID-19 patients between March and August 2020 from 16 Portuguese intensive care units. The peak and plateau periods, respectively, weeks 10 - 16 and 17 - 34, were defined.
RESULTS: Five hundred forty-one adult patients with a median age of 65 [57 - 74] years, mostly male (71.2%), were included. There were no significant differences in median age (p = 0.3), Simplified Acute Physiology Score II (40 versus 39; p = 0.8), partial arterial oxygen pressure/fraction of inspired oxygen ratio (139 versus 136; p = 0.6), antibiotic therapy (57% versus 64%; p = 0.2) at admission, or 28-day mortality (24.4% versus 22.8%; p = 0.7) between the peak and plateau periods. During the peak period, patients had fewer comorbidities (1 [0 - 3] versus 2 [0 - 5]; p = 0.002) and presented a higher use of vasopressors (47% versus 36%; p < 0.001) and invasive mechanical ventilation (58.1 versus 49.2%; p < 0.001) at admission, prone positioning (45% versus 36%; p = 0.04), and hydroxychloroquine (59% versus 10%; p < 0.001) and lopinavir/ritonavir (41% versus 10%; p < 0.001) prescriptions. However, a greater use of high-flow nasal cannulas (5% versus 16%, p < 0.001) on admission, remdesivir (0.3% versus 15%; p < 0.001) and corticosteroid (29% versus 52%, p < 0.001) therapy, and a shorter ICU length of stay (12 days versus 8, p < 0.001) were observed during the plateau.
CONCLUSION: There were significant changes in patient comorbidities, intensive care unit therapies and length of stay between the peak and plateau periods of the first COVID-19 wave.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
|---|---|
| Enthalten in: |
Revista Brasileira de terapia intensiva - 34(2022), 4 vom: 03. Okt., Seite 433-442 |
| Sprache: |
Portugiesisch |
|---|
| Weiterer Titel: |
O que mudou entre os períodos de pico e de platô durante a primeira onda do SARS-CoV-2? Estudo multicêntrico português em unidades de cuidados intensivos |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 10.03.2023 Date Revised 11.03.2023 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.5935/0103-507X.20210037-pt |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM353945501 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM353945501 | ||
| 003 | DE-627 | ||
| 005 | 20231226061145.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2022 xx |||||o 00| ||por c | ||
| 024 | 7 | |a 10.5935/0103-507X.20210037-pt |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1179.xml |
| 035 | |a (DE-627)NLM353945501 | ||
| 035 | |a (NLM)36888823 | ||
| 035 | |a (PII)S0103-507X2022000400433 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a por | ||
| 245 | 1 | 0 | |a What changed between the peak and plateau periods of the first COVID-19 pandemic wave? A multicentric Portuguese cohort study in intensive care |
| 246 | 3 | 3 | |a O que mudou entre os períodos de pico e de platô durante a primeira onda do SARS-CoV-2? Estudo multicêntrico português em unidades de cuidados intensivos |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 10.03.2023 | ||
| 500 | |a Date Revised 11.03.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To analyze and compare COVID-19 patient characteristics, clinical management and outcomes between the peak and plateau periods of the first pandemic wave in Portugal | ||
| 520 | |a METHODS: This was a multicentric ambispective cohort study including consecutive severe COVID-19 patients between March and August 2020 from 16 Portuguese intensive care units. The peak and plateau periods, respectively, weeks 10 - 16 and 17 - 34, were defined | ||
| 520 | |a RESULTS: Five hundred forty-one adult patients with a median age of 65 [57 - 74] years, mostly male (71.2%), were included. There were no significant differences in median age (p = 0.3), Simplified Acute Physiology Score II (40 versus 39; p = 0.8), partial arterial oxygen pressure/fraction of inspired oxygen ratio (139 versus 136; p = 0.6), antibiotic therapy (57% versus 64%; p = 0.2) at admission, or 28-day mortality (24.4% versus 22.8%; p = 0.7) between the peak and plateau periods. During the peak period, patients had fewer comorbidities (1 [0 - 3] versus 2 [0 - 5]; p = 0.002) and presented a higher use of vasopressors (47% versus 36%; p < 0.001) and invasive mechanical ventilation (58.1 versus 49.2%; p < 0.001) at admission, prone positioning (45% versus 36%; p = 0.04), and hydroxychloroquine (59% versus 10%; p < 0.001) and lopinavir/ritonavir (41% versus 10%; p < 0.001) prescriptions. However, a greater use of high-flow nasal cannulas (5% versus 16%, p < 0.001) on admission, remdesivir (0.3% versus 15%; p < 0.001) and corticosteroid (29% versus 52%, p < 0.001) therapy, and a shorter ICU length of stay (12 days versus 8, p < 0.001) were observed during the plateau | ||
| 520 | |a CONCLUSION: There were significant changes in patient comorbidities, intensive care unit therapies and length of stay between the peak and plateau periods of the first COVID-19 wave | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Oxygen |2 NLM | |
| 650 | 7 | |a S88TT14065 |2 NLM | |
| 700 | 1 | |a Sousa, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Cidade, José Pedro |e verfasserin |4 aut | |
| 700 | 1 | |a Melo, Luís |e verfasserin |4 aut | |
| 700 | 1 | |a Lopes, Diogo |e verfasserin |4 aut | |
| 700 | 1 | |a Ventura, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Aragão, Irene |e verfasserin |4 aut | |
| 700 | 1 | |a Lima Neto, Raul Miguel de Freitas |e verfasserin |4 aut | |
| 700 | 1 | |a Molinos, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Marques, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Cardoso, Nelson |e verfasserin |4 aut | |
| 700 | 1 | |a Marino, Flávio |e verfasserin |4 aut | |
| 700 | 1 | |a Monteiro, Filipa Brás |e verfasserin |4 aut | |
| 700 | 1 | |a Oliveira, Ana Pinho |e verfasserin |4 aut | |
| 700 | 1 | |a Silva, Rogério C |e verfasserin |4 aut | |
| 700 | 1 | |a Real, André Miguel Neto |e verfasserin |4 aut | |
| 700 | 1 | |a Banheiro, Bruno Sarmento |e verfasserin |4 aut | |
| 700 | 1 | |a Reis, Renato |e verfasserin |4 aut | |
| 700 | 1 | |a Adão-Serrano, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Cracium, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Valadas, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Ribeiro, João Miguel |e verfasserin |4 aut | |
| 700 | 1 | |a Póvoa, Pedro |e verfasserin |4 aut | |
| 700 | 1 | |a Tapadinhas, Camila |e verfasserin |4 aut | |
| 700 | 1 | |a Mendes, Vítor |e verfasserin |4 aut | |
| 700 | 1 | |a Coelho, Luís |e verfasserin |4 aut | |
| 700 | 1 | |a Maia, Raquel |e verfasserin |4 aut | |
| 700 | 1 | |a Freitas, Paulo Telles |e verfasserin |4 aut | |
| 700 | 1 | |a Ferreira, Isabel Amorim |e verfasserin |4 aut | |
| 700 | 1 | |a Ramires, Tiago |e verfasserin |4 aut | |
| 700 | 1 | |a Val-Flores, Luís Silva |e verfasserin |4 aut | |
| 700 | 1 | |a Cascão, Mariana |e verfasserin |4 aut | |
| 700 | 1 | |a Alves, Rita |e verfasserin |4 aut | |
| 700 | 1 | |a Rodeia, Simão C |e verfasserin |4 aut | |
| 700 | 1 | |a Barrigoto, Cleide |e verfasserin |4 aut | |
| 700 | 1 | |a Cardiga, Rosa |e verfasserin |4 aut | |
| 700 | 1 | |a Silva, Maria João Ferreira da |e verfasserin |4 aut | |
| 700 | 1 | |a Vale, Bruno |e verfasserin |4 aut | |
| 700 | 1 | |a Fonseca, Tatiana |e verfasserin |4 aut | |
| 700 | 1 | |a Rios, Ana Lúcia |e verfasserin |4 aut | |
| 700 | 1 | |a Camões, João |e verfasserin |4 aut | |
| 700 | 1 | |a Pérez, Danay |e verfasserin |4 aut | |
| 700 | 1 | |a Cabral, Susana |e verfasserin |4 aut | |
| 700 | 1 | |a Ribeiro, Maria Inês |e verfasserin |4 aut | |
| 700 | 1 | |a Mendes, João João |e verfasserin |4 aut | |
| 700 | 1 | |a Gouveia, João |e verfasserin |4 aut | |
| 700 | 1 | |a Fernandes, Susana Mendes |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Revista Brasileira de terapia intensiva |d 1998 |g 34(2022), 4 vom: 03. Okt., Seite 433-442 |w (DE-627)NLM094484147 |x 1982-4335 |7 nnns |
| 773 | 1 | 8 | |g volume:34 |g year:2022 |g number:4 |g day:03 |g month:10 |g pages:433-442 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.5935/0103-507X.20210037-pt |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 34 |j 2022 |e 4 |b 03 |c 10 |h 433-442 | ||