About: Increased mortality in patients with severe SARS-CoV-2 infection admitted within seven days of disease onset

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About: Increased mortality in patients with severe SARS-CoV-2 infection admitted within seven days of disease onset Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Increased mortality in patients with severe SARS-CoV-2 infection admitted within seven days of disease onset
Creator	Azoulay, Elie Darmon, Michael Voiriot, Guillaume Vieillard-Baron, Antoine Fartoukh, Muriel Demoule, Alexandre Géri, Guillaume Beurton, Alexandra Dres, Martin Dupont, Thibault Girodias, Lola Labbé, Vincent Zafrani, Lara
source	Medline; PMC
abstract	PURPOSE: Coronavirus disease 2019 (COVID-19) is creating an unprecedented healthcare crisis. Understanding the determinants of mortality is crucial to optimise intensive care unit (ICU) resource use and to identify targets for improving survival. METHODS: In a multicentre retrospective study, we included 379 COVID-19 patients admitted to four ICUs between 20 February and 24 April 2020 and categorised according to time from disease onset to ICU admission. A Cox proportional-hazards model identified factors associated with 28-day mortality. RESULTS: Median age was 66 years (53–68) and 292 (77%) were men. The main comorbidities included obesity and overweight (67%), hypertension (49.6%) and diabetes (30.1%). Median time from disease onset (i.e., viral symptoms) to ICU admission was 8 (6–11) days (missing for three); 161 (42.5%) patients were admitted within a week of disease onset, 173 (45.6%) between 8 and 14 days, and 42 (11.1%) > 14 days after disease onset; day 28 mortality was 26.4% (22–31) and decreased as time from disease onset to ICU admission increased, from 37 to 21% and 12%, respectively. Patients admitted within the first week had higher SOFA scores, more often had thrombocytopenia or acute kidney injury, had more limited radiographic involvement, and had significantly higher blood IL-6 levels. Age, COPD, immunocompromised status, time from disease onset, troponin concentration, and acute kidney injury were independently associated with mortality. CONCLUSION: The excess mortality in patients admitted within a week of disease onset reflected greater non-respiratory severity. Therapeutic interventions against SARS-CoV-2 might impact different clinical endpoints according to time since disease onset. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00134-020-06202-3) contains supplementary material, which is available to authorized users.
has issue date	2020-08-11(xsd:dateTime)
bibo:doi	10.1007/s00134-020-06202-3
bibo:pmid	32780165
has license	no-cc
sha1sum (hex)	9a6c27dfb687bd031dad4a38710bba0534e58c27
schema:url	https://doi.org/10.1007/s00134-020-06202-3
resource representing a document's title	Increased mortality in patients with severe SARS-CoV-2 infection admitted within seven days of disease onset
has PubMed Central identifier	PMC7417780
has PubMed identifier	32780165
schema:publication	Intensive Care Med
resource representing a document's body	covid:9a6c27dfb687bd031dad4a38710bba0534e58c27#body_text
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