ArticleJournal of clinical medicine2021
Multistate Modeling of COVID-19 Patients Using a Large Multicentric Prospective Cohort of Critically Ill Patients.
Article in Journal of clinical medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Methodological evaluation of bias in observational coronavirus disease 2019 studies on drug effectiveness.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2021Pooled it
- Multistate modelling of baseline lung allograft dysfunction in lung transplant recipients.ERJ open research · 2025Article
- Predicting COVID-19 progression in hospitalized patients in Kurdistan Province using a multi-state model.Journal of diabetes and metabolic disorders · 2025Article
- Article
- Clinical courses of acute kidney injury in hospitalized patients: a multistate analysis.Scientific reports · 2023Article
- Target trial emulation with multi-state model analysis to assess treatment effectiveness using clinical COVID-19 data.BMC medical research methodology · 2023Observational
- MSMpred: interactive modelling and prediction of individual evolution via multistate models.BMC medical research methodology · 2023Article
- Repurposing an 'Old' Drug for the Treatment of COVID-19-Related Cytokine Storm.Journal of clinical medicine · 2023Article
- Predicting 90-day survival of patients with COVID-19: Survival of Severely Ill COVID (SOSIC) scores.Annals of intensive care · 2021Article
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Authors and funding
19 authors at 8 institutions in 1 country.
Funding
Abstract
The mortality of COVID-19 patients in the intensive care unit (ICU) is influenced by their state at admission. We aimed to model COVID-19 acute respiratory distress syndrome state transitions from ICU admission to day 60 outcome and to evaluate possible prognostic factors. We analyzed a prospective French database that includes critically ill COVID-19 patients. A six-state multistate model was built and 17 transitions were analyzed either using a non-parametric approach or a Cox proportional hazard model. Corticosteroids and IL-antagonists (tocilizumab and anakinra) effects were evaluated using G-computation. We included 382 patients in the analysis: 243 patients were admitted to the ICU with non-invasive ventilation, 116 with invasive mechanical ventilation, and 23 with extracorporeal membrane oxygenation. The predicted 60-day mortality was 25.9% (95% CI: 21.8%-30.0%), 44.7% (95% CI: 48.8%-50.6%), and 59.2% (95% CI: 49.4%-69.0%) for a patient admitted in these three states, respectively. Corticosteroids decreased the risk of being invasively ventilated (hazard ratio (HR) 0.59, 95% CI: 0.39-0.90) and IL-antagonists increased the probability of being successfully extubated (HR 1.8, 95% CI: 1.02-3.17). Antiviral drugs did not impact any transition. In conclusion, we observed that the day-60 outcome in COVID-19 patients is highly dependent on the first ventilation state upon ICU admission. Moreover, we illustrated that corticosteroid and IL-antagonists may influence the intubation duration.
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