Time course of risk factors associated with mortality of 1260 critically ill patients with COVID-19 admitted to 24 Italian intensive care units.
Alberto Zanella, Gaetano Florio, Massimo Antonelli, Giacomo Bellani, Angela Berselli, Tiziana Bove, Luca Cabrini, Eleonora Carlesso, Gian Paolo Castelli, Maurizio Cecconi, Giuseppe Citerio, Irene Coloretti, Daniele Corti, Francesca Dalla Corte, Edoardo De Robertis, Giuseppe Foti, Roberto Fumagalli, Massimo Girardis, Riccardo Giudici, Lorenzo Guiotto, Thomas Länger, Lucia Mirabella, Daniela Pasero, Alessandro Protti, Marco Ranieri, Roberto Rona, Luigia Scudeller, Paolo Severgnini, Savino Spadaro, Nino Stocchetti, Martina Viganò, Antonio Artigas, Giacomo Grasselli
Abstract
PURPOSE: To evaluate the daily values and trends over time of relevant clinical, ventilatory and laboratory parameters during the intensive care unit (ICU) stay and their association with outcome in critically ill patients with coronavirus disease 19 (COVID-19). METHODS: In this retrospective-prospective multicentric study, we enrolled COVID-19 patients admitted to Italian ICUs from February 22 to May 31, 2020. Clinical data were daily recorded. The time course of 18 clinical parameters was evaluated by a polynomial maximum likelihood multilevel linear regression model, while a full joint modeling was fit to study the association with ICU outcome. RESULTS: , respiratory system compliance, driving pressure, creatinine, ferritin, and C-reactive protein showed a higher association with survival compared to the daily values. CONCLUSION: Daily values or trends over time of parameters associated with acute organ dysfunction, acid-base derangement, coagulation impairment, or systemic inflammation were associated with patient survival.