Evidence map›Paper›PMID 40133364›Full record

Observational studyScientific reports2025

Persistent mortality in critical COVID-19 ICU cases from wild-type to delta variant: A descriptive cohort study.

Lars Palmowski, André Hagedorn, Andrea Witowski, Helge Haberl, Felix Kraft, Ute Achtzehn, Detlef Kindgen-Milles, Kai Zacharowski, Axel Nierhaus, Maximilian Dietrich and 6 more

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

16 authors.

Lars Palmowski *Klinik Für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Knappschaftskrankenhaus Bochum, 44892, Bochum, Germany.
André Hagedorn *Klinik Für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Knappschaftskrankenhaus Bochum, 44892, Bochum, Germany.
Andrea WitowskiKlinik Für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Knappschaftskrankenhaus Bochum, 44892, Bochum, Germany.
Helge HaberlKlinik Für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Knappschaftskrankenhaus Bochum, 44892, Bochum, Germany.
Felix KraftKlinische Abteilung Für Allgemeine Anästhesie Und Intensivmedizin, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Ute AchtzehnKlinik Für Innere Medizin IV, Klinikum Chemnitz gGmbH, Flemmingstraße 2, 09116, Chemnitz, Germany.
Detlef Kindgen-MillesKlinik Für Anästhesiologie Und Intensivmedizin, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
Kai ZacharowskiKlinik Für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Frankfurt, Goethe Universität, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Axel NierhausKlinik Für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Maximilian DietrichKlinik Für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.
Valbona MirakajKlinik Für Anästhesiologie Und Intensivmedizin, Universitätsklinikum Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
Thea KochKlinik Und Poliklinik Für Anästhesiologie und Intensivtherapie, Universitätsklinikum Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
Patrick MeybohmUniversitätsklinikum Würzburg, Klinik und Poliklinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
Michael AdamzikKlinik Für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Knappschaftskrankenhaus Bochum, 44892, Bochum, Germany.
Lars Bergmann *Klinik Für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Knappschaftskrankenhaus Bochum, 44892, Bochum, Germany.
Tim Rahmel *Klinik Für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Knappschaftskrankenhaus Bochum, 44892, Bochum, Germany. Tim.Rahmel@ruhr-uni-bochum.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The SARS-CoV-2 pandemic led to significant advancements in treatment and vaccination, contributing to a decline in overall COVID-19-related mortality. However, it remains unclear whether the mortality rate for critical cases treated on intensive care units has also decreased. This multicentric, multinational retrospective observational study analyzed 447 critically ill COVID-19 patients treated on ICUs across ten study centers in Germany and Austria. Patients were categorized into two periods: period 1 (March 2020 to May 2021, n = 316) and period 2 (June 2021 to January 2022, n = 131). Despite evolving treatment strategies and widespread vaccine availability in period 2, 30-day mortality remained unchanged (30% in period 1 vs. 37% in period 2; HR 1.26, 95% CI: 0.90-1.79, p = 0.181). Further outcomes, including ICU-free days (p = 0.735), ventilatory support-free days (p = 0.699), vasopressor-free days (p = 0.379), and dialysis-free days (p = 0.396), also showed no significant differences. Notably, 81% (106 of 131) of ICU patients in period 2 were unvaccinated, underscoring the persistent vulnerability of this group. These findings suggest that while public health measures reduced overall COVID-19 severity, critical illness remained highly lethal. Further research is needed to explore targeted interventions for high-risk ICU patients and to better understand the factors contributing to persistent mortality despite medical advancements.

Indexed as

COVID-19Intensive Care UnitsSARS-CoV-2AdultAgedAustriaCritical IllnessFemaleGermanyHospital MortalityHumansMaleMiddle AgedRetrospective StudiesCOVID-19, Pandemic, SARS-CoV-2, Critical illness, ICU mortality, Virus variants

Identifiers

PMID40133364
PMCPMC11937503

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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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.