ArticleIntensive care medicine2021
Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months.
Article in Intensive care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
61 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Joint statement on evidence-based practices in mechanical ventilation: suggestions from two Brazilian medical societies.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2025Guideline
- SARS-CoV-2 and chronic myeloid leukemia: a systematic review.Frontiers in medicine · 2023Pooled it
- Frailty and mortality associations in patients with COVID-19: a systematic review and meta-analysis.Internal medicine journal · 2022Pooled it
- Mortality and Clinical Interventions in Critically ill Patient With Coronavirus Disease 2019: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2021Pooled it
- Trial
- Prediction of intensive care admission and hospital mortality in COVID-19 patients using demographics and baseline laboratory data.Clinics (Sao Paulo, Brazil) · 2023Trial
- Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19: an investigator-initiated international meta-trial of randomised clinical studies.EClinicalMedicine · 2025Article
- Weekend Effect and Predictors of Mortality for Patients Presenting to Emergency Department with COVID-19 Infection.Journal of personalized medicine · 2025Article
- A comparative analysis of clinical characteristics between primary and recurrent COVID-19 infections in China.Infectious medicine · 2025Article
- Research Advance of Causal Inference in Clinical Medicine: A Bibliometrics Analysis via Citespace.Journal of multidisciplinary healthcare · 2025Review
- Clinical management and outcomes in severe COVID-19: acute respiratory distress syndrome across two waves.Revista da Escola de Enfermagem da U S P · 2025Article
- Joint statement on evidence-based practices in mechanical ventilation: suggestions from two Brazilian medical societies.Critical care science · 2025Article
- Sociodemographic, Clinical, and Ventilatory Factors Influencing COVID-19 Mortality in the ICU of a Hospital in Colombia.Healthcare (Basel, Switzerland) · 2024Article
- Epidemiology, clinical and biological characteristics, and prognosis of critically ill COVID 19 patients: a single-center experience through 4 successive waves.Pneumonia (Nathan Qld.) · 2024Article
- Effect of immediate initiation of invasive ventilation on mortality in acute hypoxemic respiratory failure: a target trial emulation.Critical care (London, England) · 2024Article
- Characteristics and outcome of COVID-19 patients admitted to the ICU: a nationwide cohort study on the comparison between the consecutive stages of the COVID-19 pandemic in the Netherlands, an update.Annals of intensive care · 2024Article
- Comparison of the effectiveness of awake-prone positioning and high-flow nasal oxygen in patients with COVID-19-related acute respiratory failure between different waves.Critical care science · 2024Article
- Article
- Generalizing the application of machine learning predictive models across different populations: does a model to predict the use of renal replacement therapy in critically ill COVID-19 patients apply to general intensive care unit patients?Critical care science · 2024Article
- Frailty in Critically Ill Patients with COVID-19: The Lessons Learned.Advances in experimental medicine and biology · 2024Review
1 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeClinical characteristics and management of COVID-19 patients have evolved during the pandemic, potentially changing their outcomes. We analyzed the associations of changes in mortality rates with clinical profiles and respiratory support strategies in COVID-19 critically ill patients.
methodsA multicenter cohort of RT-PCR-confirmed COVID-19 patients admitted at 126 Brazilian intensive care units between February 27
resultsAmong the 13,301 confirmed-COVID-19 patients, 60-day in-hospital mortality was 13%. Across four time periods identified, younger patients were progressively more common, non-invasive respiratory support was increasingly used, and the 60-day in-hospital mortality decreased in the last two periods. 4188 patients received advanced respiratory support (non-invasive or invasive), from which 42% underwent only invasive mechanical ventilation, 37% only non-invasive respiratory support and 21% failed non-invasive support and were intubated. After adjusting for organ dysfunction scores and premorbid conditions, we found that younger age, absence of frailty and the use of non-invasive respiratory support (NIRS) as first support strategy were independently associated with improved survival (hazard ratio for NIRS first [95% confidence interval], 0.59 [0.54-0.65], p < 0.001).
conclusionAge and mortality rates have declined over the first 8 months of the pandemic. The use of NIRS as the first respiratory support measure was associated with survival, but causal inference is limited by the observational nature of our data.
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