Organizational aspects of care associated with mortality in critically ill COVID-19 patients

Rimmelé, Thomas; Pascal, Léa; Polazzi, Stéphanie; Duclos, Antoine

doi:10.1007/s00134-020-06249-2

Cited by 28 publications

(35 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In areas particularly affected by the virus spread, the tremendous number of patients coming to hospital overwhelmed hospital resources 12 . As a consequence, the local capacity to rapidly test patients in order to confirm or rule out COVID‐19 diagnosis and consequently optimize patients' triage has appeared as a major factor in the fight against COVID‐19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…In areas particularly affected by the virus spread, the tremendous number of patients coming to hospital overwhelmed hospital resources. 12 As a consequence, the local capacity to rapidly test patients in order to confirm or rule out COVID-19 diagnosis and consequently optimize patients' triage has appeared as a major factor in the fight against COVID-19 pandemic. Due to the surge of patients, resources to address the diagnosis (routinely achieved by detection of SARS-CoV-2 RNA in nasopharyngeal swabs via RT-PCR) in a timely F I G U R E 1 Gating strategy (illustrative examples).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Monocyte CD169 expression in COVID‐19 patients upon intensive care unit admission

et al. 2021

Self Cite

View full text Add to dashboard Cite

During the second surge of COVID‐19 in France (fall 2020), we assessed the expression of monocyte CD169 (i.e., Siglec‐1, one of the numerous IFN‐stimulated genes) upon admission to intensive care units of 45 patients with RT‐PCR‐confirmed SARS‐CoV2 pulmonary infection. Overall, CD169 expression was strongly induced on circulating monocytes of COVID‐19 patients compared with healthy donors and patients with bacterial sepsis. Beyond its contribution at the emergency department, CD169 testing may be also helpful for patients' triage at the ICU to rapidly reinforce suspicion of COVID‐19 etiology in patients with acute respiratory failure awaiting for PCR results for definitive diagnosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Monocyte CD169 expression in COVID‐19 patients upon intensive care unit admission

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Healthcare systems have struggled to provide care to large numbers of severely ill patients. Rimmelé et al published a multicentre retrospective observational study of 9809 patients with COVID-19 in French ICUs between January and April, 2020 [18]. They reported increased mortality in the regions of France with the highest rates of COVID-19 (Paris and the northeast), as well as during periods with potentially fewer healthcare workers.…”

Section: Healthcare Organization and Healthcare Worker Stressmentioning

confidence: 99%

Twenty articles that critical care clinicians should read about COVID-19

2021

View full text Add to dashboard Cite

Infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was first identified in December 2019 and has since become a worldwide pandemic, challenging and sometimes overwhelming healthcare systems as well as causing more than a million deaths thus far. In just 10 months, over 80,000 indexed publications have appeared that reference SARS-CoV-2 and the associated Coronavirus disease 2019 . In this article, we highlight 20 papers that are of particular relevance to the critical care clinician. The papers are divided into four broad topics: manifestations of severe COVID-19 disease, pharmacological therapy for COVID-19, ventilatory support for COVID-19 acute respiratory distress syndrome (ARDS), and healthcare system and worker stress. This list is not designed to be comprehensive but rather to give the reader an overview of important early papers and their findings. Manifestations of severe COVID-19 diseaseCOVID-19-associated ARDS is the hallmark of severe COVID-19 infection. Although it fulfills clinical criteria for ARDS, there may be important differences between COVID-19 ARDS and "classical" ARDS. A prospective study by Graselli et al. of 301 patients with COVID-19 ARDS highlighted several important differences. Firstly, mean static compliance was higher in COVID-19 ARDS (42 vs 31 mL/cm H 2 O) relative to classical ARDS, although most patients had static compliance within the 95% confidence interval (CI) for classical ARDS [1]. Secondly, in COVID-19 ARDS static compliance and PaO 2 / FiO 2 ratios did not correlate, indicating that hypoxemia is not closely tied to lung stiffness in these patients, unlike in classical ARDS. Finally, D-dimer levels were markedly elevated in COVID-19 ARDS (median 1880 ng/ mL) and higher D-dimer levels correlated with increased dead space ventilation and higher mortality. In the subset of patients who underwent CT angiogram, those with D-dimer levels above the median showed evidence of bilateral hypoperfusion. All of these data suggest a role for intravascular pathology in COVID-19 ARDS.An autopsy study from Ackermann et al. shed additional light on the differences between COVID-19 ARDS and classical ARDS [2]. The authors compared 7 lungs from patients with COVID-19 ARDS with 7 lungs from patients with influenza-associated ARDS. All of the lungs showed diffuse alveolar damage with perivascular T-cell infiltration; however, the COVID-19 lungs also showed widespread thrombosis with microangiopathy and angiogenesis, confirming the presence of pulmonary vascular disease in patients with COVID-19 ARDS.Early COVID-19 ARDS can present with relatively preserved aeration on chest imaging in spite of severe hypoxemia. In some patients this, early, high-compliance phenotype evolves into a low-compliance phenotype with poor aeration. Gattinoni et al. described these 2 clinical presentations as the "L-type" (Low elastance, high compliance, preserved aeration) and "H-type" (High elastance, low compliance, poor aeration) phenotypes. Although they likely describe a continuous a...

show abstract

“…The spread of the coronavirus disease 2019 (COVID-19) pandemic has shown important spatial heterogeneity of in-hospital COVID-19 cases and deaths between countries and regions. Across metropolitan France, the healthcare system has been overwhelmed by the pandemic surge unequally over the regions, leading to the inability to provide care in areas with outpaced resources [ 1 , 2 ]. In response, mass inter-regional transfers of critically ill patients have been organized.…”

mentioning

confidence: 99%

Inter-regional transfers for pandemic surges were associated with reduced mortality rates

et al. 2021

View full text Add to dashboard Cite

Organizational aspects of care associated with mortality in critically ill COVID-19 patients

Cited by 28 publications

References 5 publications

Monocyte CD169 expression in COVID‐19 patients upon intensive care unit admission

Monocyte CD169 expression in COVID‐19 patients upon intensive care unit admission

Twenty articles that critical care clinicians should read about COVID-19

Inter-regional transfers for pandemic surges were associated with reduced mortality rates

Contact Info

Product

Resources

About