ArticleAnnals of intensive care2021
Lactate is associated with mortality in very old intensive care patients suffering from COVID-19: results from an international observational study of 2860 patients.
Article in Annals of intensive care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04321265 (Outcomes and Prognostic Factors in Coronavirus Disease), which is not on this map. Cited by 34 papers.
What it found
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The trial behind it
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.
Outcomes and Prognostic Factors in Coronavirus Disease (COVID-19) in Very Old Intensive Care Patients
Who cites it
34 citing papers in PubMed.
- Sublingual microcirculatory assessment on admission independently predicts the outcome of old intensive care patients suffering from shock.Scientific reports · 2024Trial
- Retrospective Cohort Analysis of TyG, TyG-SI, and TyG-Lac Indices as Predictors of 360-Day Mortality in Critically Ill Ischemic Stroke Patients.Journal of clinical medicine · 2026Article
- The role of serum lactate and hypotension in mortality risk stratification for critically ill COVID-19 patients: insights from a large retrospective ICU cohort.BMC infectious diseases · 2025Article
- Age-related differences in sepsis outcomes: A comparative analysis of elderly and very elderly ICU patients.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2025Article
- The impact of withholding and withdrawal life-sustaining treatment issues on patients with sepsis: a prospective, nationwide, multicenter cohort study.Scientific reports · 2025Article
- Hemoperfusion Combined With Continuous Renal Replacement Therapy in the Management of ARDS COVID-19 Patients: A Quasi-Experimental Study.Health science reports · 2025Article
- CT-based whole lung radiomics nomogram to identify middle-aged and elderly COVID-19 patients at high risk of progressing to critical disease.Journal of applied clinical medical physics · 2025Article
- Evaluating lymphocyte change rate and lactate as predictors of prognosis in critical COVID-19 patients in the intensive care unit.Frontiers in cellular and infection microbiology · 2025Article
- Association between lactate/albumin ratio and prognosis in critically ill patients with acute kidney injury undergoing continuous renal replacement therapy.Renal failure · 2024Article
- Normalized lactate load as an independent prognostic indicator in patients with cardiogenic shock.BMC cardiovascular disorders · 2024Article
- Clinical Characteristics and Prognosis of Older Patients with Coronavirus Disease 2019 Requiring Mechanical Ventilation.Journal of personalized medicine · 2024Article
- Clinical Manifestations and Outcomes of Older Patients with COVID-19: A Comprehensive Review.Tuberculosis and respiratory diseases · 2024Article
- Acute Kidney Injury and Chronic Kidney Disease and Their Impacts on Prognosis among Patients with Severe COVID-19 Pneumonia: An Expert Center Case-Cohort Study.Journal of clinical medicine · 2024Article
- An AI-powered patient triage platform for future viral outbreaks using COVID-19 as a disease model.Human genomics · 2023Article
- The risk of venous thromboembolism and blood hyperlactatemia is associated with increased mortality among critically ill patients with Covid-19.The clinical respiratory journal · 2023Article
- The Real Impact of Age on Mortality in Critically Ill COVID-19 Patients.Journal of personalized medicine · 2023Article
- [Evolución de marcadores de laboratorio en pacientes con detección persistente de SARS-CoV-2.]Revista espanola de salud publica · 2023Article
- SARS-CoV-2 N protein mediates intercellular nucleic acid dispersion, a feature reduced in Omicron.iScience · 2023Article
- Prognostic Role of Monocyte Distribution Width, CRP, Procalcitonin and Lactate as Sepsis Biomarkers in Critically Ill COVID-19 Patients.Journal of clinical medicine · 2023Article
- Role of serum lactate as prognostic marker of mortality among emergency department patients with multiple conditions: A systematic review.SAGE open medicine · 2023Review
Corrections and comments
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Authors and funding
30 authors.
Funding
Abstract
purposeLactate is an established prognosticator in critical care. However, there still is insufficient evidence about its role in predicting outcome in COVID-19. This is of particular concern in older patients who have been mostly affected during the initial surge in 2020.
methodsThis prospective international observation study (The COVIP study) recruited patients aged 70 years or older (ClinicalTrials.gov ID: NCT04321265) admitted to an intensive care unit (ICU) with COVID-19 disease from March 2020 to February 2021. In addition to serial lactate values (arterial blood gas analysis), we recorded several parameters, including SOFA score, ICU procedures, limitation of care, ICU- and 3-month mortality. A lactate concentration ≥ 2.0 mmol/L on the day of ICU admission (baseline) was defined as abnormal. The primary outcome was ICU-mortality. The secondary outcomes 30-day and 3-month mortality.
resultsIn total, data from 2860 patients were analyzed. In most patients (68%), serum lactate was lower than 2 mmol/L. Elevated baseline serum lactate was associated with significantly higher ICU- and 3-month mortality (53% vs. 43%, and 71% vs. 57%, respectively, p < 0.001). In the multivariable analysis, the maximum lactate concentration on day 1 was independently associated with ICU mortality (aOR 1.06 95% CI 1.02-1.11; p = 0.007), 30-day mortality (aOR 1.07 95% CI 1.02-1.13; p = 0.005) and 3-month mortality (aOR 1.15 95% CI 1.08-1.24; p < 0.001) after adjustment for age, gender, SOFA score, and frailty. In 826 patients with baseline lactate ≥ 2 mmol/L sufficient data to calculate the difference between maximal levels on days 1 and 2 (∆ serum lactate) were available. A decreasing lactate concentration over time was inversely associated with ICU mortality after multivariate adjustment for SOFA score, age, Clinical Frailty Scale, and gender (aOR 0.60 95% CI 0.42-0.85; p = 0.004).
conclusionIn critically ill old intensive care patients suffering from COVID-19, lactate and its kinetics are valuable tools for outcome prediction. TRIAL REGISTRATION NUMBER: NCT04321265.
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