Evidence map›Paper›PMID 36575394›Full record

ArticleBMC geriatrics2022

The association of prior paracetamol intake with outcome of very old intensive care patients with COVID-19: results from an international prospective multicentre trial.

Philipp Heinrich Baldia, Bernhard Wernly, Hans Flaatten, Jesper Fjølner, Antonio Artigas, Bernardo Bollen Pinto, Joerg C Schefold, Malte Kelm, Michael Beil, Raphael Romano Bruno and 17 more

Registry-linked trialOpen access · goldAbstract readMulticenter Study
In one paragraph

Article in BMC geriatrics, 2022. 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 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

NCT04321265 unknown statusnot on this map

Outcomes and Prognostic Factors in Coronavirus Disease (COVID-19) in Very Old Intensive Care Patients

TypeobservationalSponsorHeinrich-Heine University, DuesseldorfRan2020 to 2023Enrolled1,500ConditionsCOVID-19, Elderly Patients, Critical Illness, Survival
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors at 18 institutions in 14 countries.

Philipp Heinrich BaldiaDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
Bernhard WernlyDepartment of Anaesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria.
Hans FlaattenDepartment of Clinical Medicine, Department of Anaestesia and Intensive Care, University of Bergen, Haukeland University Hospital, Bergen, Norway.
Jesper FjølnerDepartment of Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
Antonio ArtigasCritical Care Centre, Sabadell Hospital University Institute Parc Tauli, Sabadell Barcelona, Spain.
Bernardo Bollen PintoDepartment of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland.
Joerg C SchefoldDepartment of Intensive Care Medicine, Inselspital, Universitätsspital, University of Bern, Bern, Switzerland.
Malte KelmDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
Michael BeilGeneral & Medical Intensive Care Units, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Raphael Romano BrunoDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
Stephan BinnebößelDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
Georg WolffDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
Ralf ErkensDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
Sviri SigalGeneral & Medical Intensive Care Units, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Peter Vernon van HeerdenGeneral & Medical Intensive Care Units, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Wojciech SzczeklikDepartment of Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland.
Muhammed ElhadiFaculty of Medicine, University of Tripoli, Tripoli, Libya.
Michael JoannidisDivision of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria.
Sandra OeyenDepartment of Intensive Care 1K12IC, Ghent University Hospital, Ghent, Belgium.
Brian MarshMater Misericordiae University Hospital, Dublin, Ireland.
Finn H AndersenDepartment Of Anaesthesia and Intensive Care, Ålesund Hospital, Ålesund, Norway. Dep. of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
Rui MorenoMultipurpose and Neurocritical Intensive Care Unit, Hospital of São José, Central Lisbon University Hospital Centre, Lisbon, Portugal.
Susannah LeaverGeneral Intensive Care, St George´S University Hospitals NHS Foundation Trust, London, UK.
Dylan W De LangeDepartment of Intensive Care Medicine, University Medical Center, University Utrecht, Utrecht, Netherlands.
Bertrand GuidetInstitute Pierre Louis Epidemiology and Public Health, Medical Intensive Care Unit, Sorbonne University, UPMC, INSERM, Hôpital Saint-Antoine, Paris, France.
Christian JungDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany. christian.jung@med.uni-duesseldorf.de.
COVIP study group
Heinrich Heine University Düsseldorf · DEInnsbruck Medical University · ATHebrew University of Jerusalem · ILUniversity Medical Center Utrecht · NLHospital de São José · PTSt George’s University Hospitals NHS Foundation Trust · GBUniversity of Tripoli · LYAarhus University Hospital · DKDeleted InstitutionGhent University Hospital · BEHaukeland University Hospital · NOInserm · FRJagiellonian University · PLMater Misericordiae University Hospital · IENorwegian University of Science and Technology · NOParacelsus Medical University · ATUniversity Hospital of Geneva · CHUniversity of Bern · CH

Funding

Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf 2018-32Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf 2020-21
6 · The paper itself

Abstract

backgroundIn the early COVID-19 pandemic concerns about the correct choice of analgesics in patients with COVID-19 were raised. Little data was available on potential usefulness or harmfulness of prescription free analgesics, such as paracetamol. This international multicentre study addresses that lack of evidence regarding the usefulness or potential harm of paracetamol intake prior to ICU admission in a setting of COVID-19 disease within a large, prospectively enrolled cohort of critically ill and frail intensive care unit (ICU) patients.

methodsThis prospective international observation study (The COVIP study) recruited ICU patients ≥ 70 years admitted with COVID-19. Data on Sequential Organ Failure Assessment (SOFA) score, prior paracetamol intake within 10 days before admission, ICU therapy, limitations of care and survival during the ICU stay, at 30 days, and 3 months. Paracetamol intake was analysed for associations with ICU-, 30-day- and 3-month-mortality using Kaplan Meier analysis. Furthermore, sensitivity analyses were used to stratify 30-day-mortality in subgroups for patient-specific characteristics using logistic regression.

results44% of the 2,646 patients with data recorded regarding paracetamol intake within 10 days prior to ICU admission took paracetamol. There was no difference in age between patients with and without paracetamol intake. Patients taking paracetamol suffered from more co-morbidities, namely diabetes mellitus (43% versus 34%, p < 0.001), arterial hypertension (70% versus 65%, p = 0.006) and had a higher score on Clinical Frailty Scale (CFS; IQR 2-5 versus IQR 2-4, p < 0.001). Patients under prior paracetamol treatment were less often subjected to intubation and vasopressor use, compared to patients without paracetamol intake (65 versus 71%, p < 0.001; 63 versus 69%, p = 0.007). Paracetamol intake was not associated with ICU-, 30-day- and 3-month-mortality, remaining true after multivariate adjusted analysis.

conclusionParacetamol intake prior to ICU admission was not associated with short-term and 3-month mortality in old, critically ill intensive care patients suffering from COVID-19.

trial registrationThis prospective international multicentre study was registered on ClinicalTrials.gov with the identifier "NCT04321265" on March 25, 2020.

Indexed as

COVID-19AcetaminophenCritical CareCritical IllnessHumansPandemicsProspective StudiesAcetaminophenAnalgesicsCOVID-19FrailtyICUParacetamol

Identifiers

PMID36575394
PMCPMC9794407
OpenAlexW4313250749

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.