tetano
Editor, Senior Moderator
Am J Trop Med Hyg
. 2025 Jan 21:tpmd240257.
doi: 10.4269/ajtmh.24-0257. Online ahead of print. Epidemiology, Ventilation Management, and Outcomes in Invasively Ventilated Coronavirus Disease 2019 Patients: An Analysis of Four Observational Studies in Four Countries on Two Continents
Siebe G Blok[SUP] 1 [/SUP], Luigi Pisani[SUP] 1 2 [/SUP]; Elisa Estenssoro for SATI-COVID-19 investigators[SUP] 3 [/SUP]; Juliana Carvalho Ferreira for EPICCoV investigators[SUP] 4 [/SUP]; Michela Botta[SUP] 1 [/SUP], Ana Motos[SUP] 5 6 [/SUP], Ignacio Martin-Loeches[SUP] 7 [/SUP]; Antoni Torres for CIBERESUCICOVID investigators[SUP] 5 6 [/SUP]; Marcus J Schultz[SUP] 1 2 8 9 [/SUP]; Frederique Paulus for PRoVENT-COVID investigators[SUP] 1 10 [/SUP]; David M. P. van Meenen for PRoVENT-COP investigators[SUP] 1 11 [/SUP]
Affiliations
Epidemiology, ventilator management, and outcomes in patients with acute respiratory distress syndrome (ARDS) because of coronavirus disease 2019 (COVID-19) have been described extensively but have never been compared between countries. We performed an individual patient data analysis of four observational studies to compare epidemiology, ventilator management, and outcomes. We used propensity score weighting to control for confounding factors. The analysis included 6,702 patients: 1,500 from Argentina, 844 from Brazil, 975 from the Netherlands, and 3,383 from Spain. There were substantial differences in baseline characteristics between countries. There were small differences in ventilation management. Intensive care unit mortality was higher in Argentina and Brazil compared with the Netherlands and Spain (59.6% and 56.6% versus 32.1% and 34.7%; P <0.001). The median number of days free from ventilation and alive at day 28 was equally low (0 [0-7], 0 [0-18], 1 [0-16], and 0 [0-16] days, respectively; P = 0.03), and the median number of days free from ventilation and alive at day 60 was higher in the Netherlands and Spain (0 [0-37], 0 [0-50], 33 [0-48], and 26 [0-48] days, respectively; P <0.001). Propensity score matching confirmed the outcome differences. Thus, the outcome of COVID-19 ARDS patients in Argentina and Brazil was substantially worse compared with that of patients in the Netherlands and Spain. It is unlikely that this results from differences in case mix or ventilation management.
. 2025 Jan 21:tpmd240257.
doi: 10.4269/ajtmh.24-0257. Online ahead of print. Epidemiology, Ventilation Management, and Outcomes in Invasively Ventilated Coronavirus Disease 2019 Patients: An Analysis of Four Observational Studies in Four Countries on Two Continents
Siebe G Blok[SUP] 1 [/SUP], Luigi Pisani[SUP] 1 2 [/SUP]; Elisa Estenssoro for SATI-COVID-19 investigators[SUP] 3 [/SUP]; Juliana Carvalho Ferreira for EPICCoV investigators[SUP] 4 [/SUP]; Michela Botta[SUP] 1 [/SUP], Ana Motos[SUP] 5 6 [/SUP], Ignacio Martin-Loeches[SUP] 7 [/SUP]; Antoni Torres for CIBERESUCICOVID investigators[SUP] 5 6 [/SUP]; Marcus J Schultz[SUP] 1 2 8 9 [/SUP]; Frederique Paulus for PRoVENT-COVID investigators[SUP] 1 10 [/SUP]; David M. P. van Meenen for PRoVENT-COP investigators[SUP] 1 11 [/SUP]
Affiliations
- PMID: 39842032
- DOI: 10.4269/ajtmh.24-0257
Epidemiology, ventilator management, and outcomes in patients with acute respiratory distress syndrome (ARDS) because of coronavirus disease 2019 (COVID-19) have been described extensively but have never been compared between countries. We performed an individual patient data analysis of four observational studies to compare epidemiology, ventilator management, and outcomes. We used propensity score weighting to control for confounding factors. The analysis included 6,702 patients: 1,500 from Argentina, 844 from Brazil, 975 from the Netherlands, and 3,383 from Spain. There were substantial differences in baseline characteristics between countries. There were small differences in ventilation management. Intensive care unit mortality was higher in Argentina and Brazil compared with the Netherlands and Spain (59.6% and 56.6% versus 32.1% and 34.7%; P <0.001). The median number of days free from ventilation and alive at day 28 was equally low (0 [0-7], 0 [0-18], 1 [0-16], and 0 [0-16] days, respectively; P = 0.03), and the median number of days free from ventilation and alive at day 60 was higher in the Netherlands and Spain (0 [0-37], 0 [0-50], 33 [0-48], and 26 [0-48] days, respectively; P <0.001). Propensity score matching confirmed the outcome differences. Thus, the outcome of COVID-19 ARDS patients in Argentina and Brazil was substantially worse compared with that of patients in the Netherlands and Spain. It is unlikely that this results from differences in case mix or ventilation management.