What changed between the peak and plateau periods of the first COVID-19 pandemic wave? A multicentric Portuguese cohort study in intensive care - Critical Care Science (CCS)
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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.
Pereira RA, Sousa M, Cidade JP, Melo L, Lopes D, Ventura S, Aragão I, et al. What changed between the peak and plateau periods of the first COVID-19 pandemic wave? A multicentric Portuguese cohort study in intensive care. Rev Bras Ter Intensiva 2023;34(4):433-42.
Electronic Document Format (ABNT)
Pereira, Rui Antunes; Sousa, Marta; Cidade, José Pedro; Melo, Luís; Lopes, Diogo; Ventura, Sara; Aragão, Irene; Lima Neto, Raul Miguel de Freitas; Molinos, Elena; Marques, Ana; Cardoso, Nelson; Marino, Flávio; Monteiro, Filipa Brás; Oliveira, Ana Pinho; Silva, Rogério C; Real, André Miguel Neto; Banheiro, Bruno Sarmento; Reis, Renato; Adão-Serrano, Maria; Cracium, Ana; Valadas, Ana; Ribeiro, João Miguel; Póvoa, Pedro; Tapadinhas, Camila; Mendes, Vítor; Coelho, Luís; Maia, Raquel; Freitas, Paulo Telles; Ferreira, Isabel Amorim; Ramires, Tiago; Val-Flores, Luís Silva; Cascão, Mariana; Alves, Rita; Rodeia, Simão C; Barrigoto, Cleide; Cardiga, Rosa; Silva, Maria João Ferreira da; Vale, Bruno; Fonseca, Tatiana; Rios, Ana Lúcia; Camões, João; Pérez, Danay; Cabral, Susana; Ribeiro, Maria Inês; Mendes, João João; Gouveia, João; Fernandes, Susana Mendes. What changed between the peak and plateau periods of the first COVID-19 pandemic wave? A multicentric Portuguese cohort study in intensive care. Rev Bras Ter Intensiva, v. 34, n. 4, p. 433-442, Jan. 2023.
Electronic Document Format (APA)
Pereira, R. A., Sousa, M., Cidade, J. P., Melo, L., Lopes, D., Ventura, S., Aragão, I., Lima Neto, R. M. F., Molinos, E., Marques, A., Cardoso, N., Marino, F., Monteiro, F. B., Oliveira, A. P., Silva, R. C., Real, A. M. N., Banheiro, B. S., Reis, R., Adão-Serrano, M., Cracium, A., Valadas, A., Ribeiro, J. M., Póvoa, P., Tapadinhas, C., Mendes, V., Coelho, L., Maia, R., Freitas, P. T., Ferreira, I. A., Ramires, T., Val-Flores, L. S., Cascão, M., Alves, R., Rodeia, S. C., Barrigoto, C., Cardiga, R., Silva, M. J. F. , Vale, B., Fonseca, T., Rios, A. L., Camões, J., Pérez, D., Cabral, S., Ribeiro, M. I., Mendes, J. J., Gouveia, J., & Fernandes, S. M. (2023). What changed between the peak and plateau periods of the first COVID-19 pandemic wave? A multicentric Portuguese cohort study in intensive care. Rev Bras Ter Intensiva, 34(4), 433-442.
Electronic Document Format (ISO)
Pereira, Rui Antunes and Sousa, Marta and Cidade, José Pedro and Melo, Luís and Lopes, Diogo and Ventura, Sara and Aragão, Irene and Lima Neto, Raul Miguel de Freitas and Molinos, Elena and Marques, Ana and Cardoso, Nelson and Marino, Flávio and Monteiro, Filipa Brás and Oliveira, Ana Pinho and Silva, Rogério C and Real, André Miguel Neto and Banheiro, Bruno Sarmento and Reis, Renato and Adão-Serrano, Maria and Cracium, Ana and Valadas, Ana and Ribeiro, João Miguel and Póvoa, Pedro and Tapadinhas, Camila and Mendes, Vítor and Coelho, Luís and Maia, Raquel and Freitas, Paulo Telles and Ferreira, Isabel Amorim and Ramires, Tiago and Val-Flores, Luís Silva and Cascão, Mariana and Alves, Rita and Rodeia, Simão C and Barrigoto, Cleide and Cardiga, Rosa and Silva, Maria João Ferreira da and Vale, Bruno and Fonseca, Tatiana and Rios, Ana Lúcia and Camões, João and Pérez, Danay and Cabral, Susana and Ribeiro, Maria Inês and Mendes, João João and Gouveia, João and Fernandes, Susana Mendes. What changed between the peak and plateau periods of the first COVID-19 pandemic wave? A multicentric Portuguese cohort study in intensive care. Rev Bras Ter Intensiva [online]. 2023, vol. 34, n. 4, [cited 2024-05-09], pp.433-442. Available from: <https://criticalcarescience.org/article/what-changed-between-the-peak-and-plateau-periods-of-the-first-covid-19-pandemic-wave-a-multicentric-portuguese-cohort-study-in-intensive-care/>.
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Figura 1 | Admissões em unidades de terapia intensiva e idade mediana dos pacientes com COVID-19.
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