Clinical and organizational factors associated with mortality during the peak of first COVID‑19 wave: the global UNITE‑COVID study.
Resumen: Purpose: To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus
disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used
for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational
characteristics associated with outcomes in critically ill COVID-19 patients.
Methods: Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection
confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th
and May 15th, 2020.
Results: 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity
from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge
capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU
stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%–50%) and ICU mortality 32.7%. Older age,
invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations
were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not
associated with mortality, even after controlling for other factors
Conclusions: ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting
up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge
capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were
identified as the strongest predictors of mortality
Identificador universal: http://hdl.handle.net/10641/3086
Fecha: 2022
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