AIMS OF THE STUDY: During the ongoing COVID-19 pandemic, the launch of a large-scale vaccination campaign and virus mutations have hinted at possible changes in transmissibility and the virulence affecting disease progression up to critical illness, and carry potential for future vaccination failure. To monitor disease development over time with respect to critically ill COVID-19 patients, we report near real-time prospective observational data from the RISC-19-ICU registry that indicate changed characteristics of critically ill patients admitted to Swiss intensive care units (ICUs) at the onset of a third pandemic wave. METHODS: 1829 of 3344 critically ill COVID-19 patients enrolled in the international RISC-19-ICU registry as of 31 May 2021 were treated in Switzerland and were included in the present study. Of these, 1690 patients were admitted to the ICU before 1 February 2021 and were compared with 139 patients admitted during the emerging third pandemic wave RESULTS: Third wave patients were a mean of 5.2 years (95% confidence interval [CI] 3.2–7.1) younger (median 66.0 years, interquartile range [IQR] 57.0–73.0 vs 62.0 years, IQR 54.5–68.0; p <0.0001) and had a higher body mass index than patients admitted in the previous pandemic period. They presented with lower SAPS II and APACHE II scores, less need for circulatory support and lower white blood cell counts at ICU admission. P/F ratio was similar, but a 14% increase in ventilatory ratio was observed over time (p = 0.03) CONCLUSION: Near real-time registry data show that the latest COVID-19 patients admitted to ICUs in Switzerland at the onset of the third wave were on average 5 years younger, had a higher body mass index, and presented with lower physiological risk scores but a trend towards more severe lung failure. These differences may primarily be related to the ongoing nationwide vaccination campaign, but the possibility that changes in virus-host interactions may be a co-factor in the age shift and change in disease characteristics is cause for concern, and should be taken into account in the public health and vaccination strategy during the ongoing pandemic. (ClinicalTrials.gov Identifier: NCT04357275).
AIMS OF THE STUDY: During the ongoing COVID-19 pandemic, the launch of a large-scale vaccination campaign and virus mutations have hinted at possible changes in transmissibility and the virulence affecting disease progression up to critical illness, and carry potential for future vaccination failure. To monitor disease development over time with respect to critically ill COVID-19 patients, we report near real-time prospective observational data from the RISC-19-ICU registry that indicate changed characteristics of critically ill patients admitted to Swiss intensive care units (ICUs) at the onset of a third pandemic wave. METHODS: 1829 of 3344 critically ill COVID-19 patients enrolled in the international RISC-19-ICU registry as of 31 May 2021 were treated in Switzerland and were included in the present study. Of these, 1690 patients were admitted to the ICU before 1 February 2021 and were compared with 139 patients admitted during the emerging third pandemic wave RESULTS: Third wave patients were a mean of 5.2 years (95% confidence interval [CI] 3.2–7.1) younger (median 66.0 years, interquartile range [IQR] 57.0–73.0 vs 62.0 years, IQR 54.5–68.0; p <0.0001) and had a higher body mass index than patients admitted in the previous pandemic period. They presented with lower SAPS II and APACHE II scores, less need for circulatory support and lower white blood cell counts at ICU admission. P/F ratio was similar, but a 14% increase in ventilatory ratio was observed over time (p = 0.03) CONCLUSION: Near real-time registry data show that the latest COVID-19 patients admitted to ICUs in Switzerland at the onset of the third wave were on average 5 years younger, had a higher body mass index, and presented with lower physiological risk scores but a trend towards more severe lung failure. These differences may primarily be related to the ongoing nationwide vaccination campaign, but the possibility that changes in virus-host interactions may be a co-factor in the age shift and change in disease characteristics is cause for concern, and should be taken into account in the public health and vaccination strategy during the ongoing pandemic. (ClinicalTrials.gov Identifier: NCT04357275).
Authors: Pedro David Wendel-Garcia; André Moser; Yok-Ai Que; Matthias Peter Hilty; Marie-Madlen Jeitziner; Hernán Aguirre-Bermeo; Pedro Arias-Sanchez; Janina Apolo; Ferran Roche-Campo; Diego Franch-Llasat; Gian-Reto Kleger; Claudia Schrag; Urs Pietsch; Miodrag Filipovic; Sascha David; Klaus Stahl; Souad Bouaoud; Amel Ouyahia; Patricia Fodor; Pascal Locher; Martin Siegemund; Nuria Zellweger; Sara Cereghetti; Peter Schott; Gianfilippo Gangitano; Maddalena Alessandra Wu; Mario Alfaro-Farias; Gerardo Vizmanos-Lamotte; Hatem Ksouri; Nadine Gehring; Emanuele Rezoagli; Fabrizio Turrini; Herminia Lozano-Gómez; Andrea Carsetti; Raquel Rodríguez-García; Bernd Yuen; Anja Baltussen Weber; Pedro Castro; Jesus Oscar Escos-Orta; Alexander Dullenkopf; Maria C Martín-Delgado; Theodoros Aslanidis; Marie-Helene Perez; Frank Hillgaertner; Samuele Ceruti; Marilene Franchitti Laurent; Julien Marrel; Riccardo Colombo; Marcus Laube; Alberto Fogagnolo; Michael Studhalter; Tobias Wengenmayer; Emiliano Gamberini; Christian Buerkle; Philipp K Buehler; Stefanie Keiser; Muhammed Elhadi; Jonathan Montomoli; Philippe Guerci; Thierry Fumeaux; Reto A Schuepbach; Stephan M Jakob Journal: Crit Care Date: 2022-07-04 Impact factor: 19.334
Authors: Matthias Peter Hilty; Emanuele Favaron; Pedro David Wendel Garcia; Yavuz Ahiska; Zuhre Uz; Sakir Akin; Moritz Flick; Sesmu Arbous; Daniel A Hofmaenner; Bernd Saugel; Henrik Endeman; Reto Andreas Schuepbach; Can Ince Journal: Crit Care Date: 2022-10-14 Impact factor: 19.334
Authors: Matthias Peter Hilty; Stefanie Keiser; Pedro D Wendel Garcia; André Moser; Reto A Schuepbach Journal: Intensive Care Med Date: 2022-01-20 Impact factor: 17.440