Sex-specific treatment characteristics and 30-day mortality outcomes of critically ill COVID-19 patients over 70 years of age-results from the prospective COVIP study.
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BORIS DOI
Date of Publication
November 2022
Publication Type
Article
Division/Institute
Contributor
Wolff, Georg | |
Wernly, Bernhard | |
Flaatten, Hans | |
Fjølner, Jesper | |
Bruno, Raphael Romano | |
Artigas, Antonio | |
Pinto, Bernardo Bollen | |
Kelm, Malte | |
Binneboessel, Stephan | |
Baldia, Philipp | |
Beil, Michael | |
Sivri, Sigal | |
van Heerden, Peter Vernon | |
Szczeklik, Wojciech | |
Elhadi, Muhammed | |
Joannidis, Michael | |
Oeyen, Sandra | |
Flamm, Maria | |
Zafeiridis, Tilemachos | |
Marsh, Brian | |
Andersen, Finn H | |
Moreno, Rui | |
Boumendil, Ariane | |
De Lange, Dylan W | |
Guidet, Bertrand | |
Leaver, Susannah | |
Jung, Christian |
Subject(s)
Series
Canadian journal of anesthesia / Journal canadien d'anesthesie
ISSN or ISBN (if monograph)
0832-610X
Publisher
Springer-Verlag
Language
English
Publisher DOI
PubMed ID
35945477
Uncontrolled Keywords
Description
PURPOSE
Older critically ill patients with COVID-19 have been the most vulnerable during the ongoing pandemic, with men being more prone to hospitalization and severe disease than women. We aimed to explore sex-specific differences in treatment and outcome after intensive care unit (ICU) admission in this cohort.
METHODS
We performed a sex-specific analysis in critically ill patients ≥ 70 yr of age with COVID-19 who were included in the international prospective multicenter COVIP study. All patients were analyzed for ICU admission and treatment characteristics. We performed a multilevel adjusted regression analysis to elucidate associations of sex with 30-day mortality.
RESULTS
A total of 3,159 patients (69.8% male, 30.2% female; median age, 75 yr) were included. Male patients were significantly fitter than female patients as determined by the Clinical Frailty Scale (fit, 67% vs 54%; vulnerable, 14% vs 19%; frail, 19% vs 27%; P < 0.001). Male patients more often underwent tracheostomy (20% vs 14%; odds ratio [OR], 1.57; P < 0.001), vasopressor therapy (69% vs 62%; OR, 1.25; P = 0.02), and renal replacement therapy (17% vs 11%; OR, 1.96; P < 0.001). There was no difference in mechanical ventilation, life-sustaining treatment limitations, and crude 30-day mortality (50% male vs 49% female; OR, 1.11; P = 0.19), which remained true after adjustment for disease severity, frailty, age and treatment limitations (OR, 1.17; 95% confidence interval, 0.94 to 1.45; P = 0.16).
CONCLUSION
In this analysis of sex-specific treatment characteristics and 30-day mortality outcomes of critically ill patients with COVID-19 ≥ 70 yr of age, we found more tracheostomy and renal replacement therapy in male vs female patients, but no significant association of patient sex with 30-day mortality.
STUDY REGISTRATION
www.
CLINICALTRIALS
gov (NCT04321265); registered 25 March 2020).
Older critically ill patients with COVID-19 have been the most vulnerable during the ongoing pandemic, with men being more prone to hospitalization and severe disease than women. We aimed to explore sex-specific differences in treatment and outcome after intensive care unit (ICU) admission in this cohort.
METHODS
We performed a sex-specific analysis in critically ill patients ≥ 70 yr of age with COVID-19 who were included in the international prospective multicenter COVIP study. All patients were analyzed for ICU admission and treatment characteristics. We performed a multilevel adjusted regression analysis to elucidate associations of sex with 30-day mortality.
RESULTS
A total of 3,159 patients (69.8% male, 30.2% female; median age, 75 yr) were included. Male patients were significantly fitter than female patients as determined by the Clinical Frailty Scale (fit, 67% vs 54%; vulnerable, 14% vs 19%; frail, 19% vs 27%; P < 0.001). Male patients more often underwent tracheostomy (20% vs 14%; odds ratio [OR], 1.57; P < 0.001), vasopressor therapy (69% vs 62%; OR, 1.25; P = 0.02), and renal replacement therapy (17% vs 11%; OR, 1.96; P < 0.001). There was no difference in mechanical ventilation, life-sustaining treatment limitations, and crude 30-day mortality (50% male vs 49% female; OR, 1.11; P = 0.19), which remained true after adjustment for disease severity, frailty, age and treatment limitations (OR, 1.17; 95% confidence interval, 0.94 to 1.45; P = 0.16).
CONCLUSION
In this analysis of sex-specific treatment characteristics and 30-day mortality outcomes of critically ill patients with COVID-19 ≥ 70 yr of age, we found more tracheostomy and renal replacement therapy in male vs female patients, but no significant association of patient sex with 30-day mortality.
STUDY REGISTRATION
www.
CLINICALTRIALS
gov (NCT04321265); registered 25 March 2020).
File(s)
| File | File Type | Format | Size | License | Publisher/Copright statement | Content | |
|---|---|---|---|---|---|---|---|
| Wolff2022_Article_Sex-specificTreatmentCharacter.pdf | text | Adobe PDF | 308.32 KB | published |