A study was conducted to assess the outcome of elderly intensive care unit patients who were treated during the spring and autumn surges of COVID-19 in Europe.
The COVIP study included patients aged 70 years and older who were admitted with COVID-19 from March to December 2020. A total of 2625 patients – 1327 from the first surge of the pandemic and 1298 from the second surge were included. The median age was 74 and 75 years in surges 1 and 2. Patients were from 159 ICUs in 14 European countries. They were evaluated on a number of parameters, including the SOFA score, the Clinical Frailty Scale, comorbidities, ICU procedures and survival at 90 days.
Findings from the study show that the SOFA score was higher in the first surge compared to the second. The PaO2/FiO2 ratio at admission was higher during the first surge of the pandemic. More patients also received invasive mechanical ventilation during the first surge (78% versus 68%).
Survival was similar for both the first and second surge during the first 15 days of treatment but was lower in the second surge after day 15 and differed after 30 days (57% vs 50%) and after 90 days (51% vs 40%).
These findings show a significant difference in the 30-day and 90-day survival between the first and second surges among elderly ICU patients. Why this was so remains unclear. It is important to consider whether the changes in practice and treatment of the patients between the surges could have played a role in increased mortality in the elderly patients with COVID-19. There is a need to conduct more studies to gather more evidence regarding the current practice in elderly patients with coronavirus disease.
Source: Critical Care
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