Pacientes críticos COVID-19. ¿Han variado el manejo y los resultados en la UCI tras un año de pandemia? Estudio multicéntrico, prospectivo, observacional / Critical patients COVID-19 has changed the management and outcomes in the ICU after 1 year of the pandemic? A multicenter, prospective, observational study

Objetivo: Comparar las características clínicas, los tratamientos y la evolución de los pacientes críticos con neumonía por COVID-19 atendidos en unidades de cuidados intensivos (UCI) tras un año de pandemia. Metodología: Estudio multicéntrico, prospectivo, en el que se incluyó pacientes críticos COVID-19 en 9 UCI del noroeste de España. Se compararon las características clínicas, los tratamientos y la evolución de pacientes ingresados en UCI durante los meses de marzo-abril de 2020 (periodo1) con pacientes ingresados en enero-febrero de 2021 (periodo2). Resultados: Se incluyeron 337 pacientes (98 en el periodo1 y 239 en el periodo2). En el periodo2 menos pacientes requirieron ventilación mecánica invasiva (VMI) (65% vs 84%, p<0,001), utilizándose con mayor frecuencia cánulas nasales de alto flujo (CNAF) (70% vs 7%, p<0,001), ventilación mecánica no invasiva (VMNI) (40% vs 14%, p<0,001), corticoides (100% vs 96%, p=0,007) y posición de decúbito prono tanto en pacientes despiertos (42% vs 28%, p=0,012) como en pacientes intubados (67% vs 54%, p=0,034). Los días de VMI, de estancia en UCI y hospitalaria fueron inferiores en el periodo2. La mortalidad fue similar en los dos periodos estudiados (16% vs 17%). Conclusiones: Tras un año de pandemia, observamos que en los pacientes ingresados en UCI se ha utilizado con mayor frecuencia CNAF, VMNI, uso del decúbito prono y corticoides, disminuyendo los pacientes en VMI, así como los tiempos de estancia en UCI y de estancia hospitalaria. La mortalidad ha sido similar en los dos periodos a estudio.(AU)

Objective: To compare the clinical characteristics, treatments, and evolution of critical patients with COVID-19 pneumonia treated in intensive care units (ICU) after one year of pandemic. Methodology: Multicenter, prospective study, which included critical COVID-19 patients in 9 ICUs in northwestern Spain. The clinical characteristics, treatments, and evolution of patients admitted to the ICU during the months of March-April 2020 (period1) were compared with patients admitted in January-February 2021 (period2). Results: 337 patients were included (98 in period1 and 239 in period2). In period2, fewer patients required invasive mechanical ventilation (IMV) (65% vs. 84%, P<.001), using high-flow nasal cannulas (CNAF) more frequently (70% vs. 7%, P<.001), ventilation non-invasive mechanical (NIMV) (40% vs. 14%, P<.001), corticosteroids (100% vs. 96%, P=.007) and prone position in both awake (42% vs. 28%, P=.012), and intubated patients (67% vs. 54%, P=.034). The days of IMV, ICU stay and hospital stay were lower in period2. Mortality was similar in the two periods studied (16% vs. 17%). Conclusions: After one year of pandemic, we observed that in patients admitted to the ICU, CNAF, NIMV, use of the prone position, and corticosteroids have been used more frequently, reducing the number of patients in IMV, and the length of stay in the ICU and hospital stay. Mortality was similar in the two study periods.(AU)

Critical patients COVID-19 has changed the management and outcomes in the ICU after 1 year of the pandemic? A multicenter, prospective, observational study.

OBJECTIVE: To compare the clinical characteristics, treatments, and evolution of critical patients with COVID-19 pneumonia treated in Intensive Care Units (ICU) after one year of pandemic. METHODOLOGY: Multicenter, prospective study, which included critical COVID-19 patients in 9 ICUs in northwestern Spain. The clinical characteristics, treatments, and evolution of patients admitted to the ICU during the months of March-April 2020 (period 1) were compared with patients admitted in January-February 2021 (period 2). RESULTS: 337 patients were included (98 in period 1 and 239 in period 2). In period 2, fewer patients required invasive mechanical ventilation (IMV) (65% vs 84%, p < 0.001), using high-flow nasal cannulas (CNAF) more frequently (70% vs 7%, p < 0.001), ventilation non-invasive mechanical (NIMV) (40% vs 14%, p < 0.001), corticosteroids (100% vs 96%, p = 0.007) and prone position in both awake (42% vs 28%, p = 0.012), and intubated patients (67% vs 54%, p = 0.034). The days of IMV, ICU stay and hospital stay were lower in period 2. Mortality was similar in the two periods studied (16% vs 17%). CONCLUSIONS: After 1 year of pandemic, we observed that in patients admitted to the ICU, CNAF, NIMV, use of the prone position, and corticosteroids have been used more frequently, reducing the number of patients in IMV, and the length of stay in the ICU and hospital stay. Mortality was similar in the two study periods.

[Critical patients COVID-19 has changed the management and outcomes in the ICU after 1 year of the pandemic? A multicenter, prospective, observational study]. / Pacientes críticos COVID-19. ¿Han variado el manejo y los resultados en la UCI tras un año de pandemia? Estudio multicéntrico, prospectivo, observacional.

Objective: To compare the clinical characteristics, treatments, and evolution of critical patients with COVID-19 pneumonia treated in intensive care units (ICU) after one year of pandemic. Methodology: Multicenter, prospective study, which included critical COVID-19 patients in 9 ICUs in northwestern Spain. The clinical characteristics, treatments, and evolution of patients admitted to the ICU during the months of March-April 2020 (period 1) were compared with patients admitted in January-February 2021 (period 2). Results: 337 patients were included (98 in period 1 and 239 in period 2). In period 2, fewer patients required invasive mechanical ventilation (IMV) (65% vs. 84%, P < .001), using high-flow nasal cannulas (CNAF) more frequently (70% vs. 7%, P < .001), ventilation non-invasive mechanical (NIMV) (40% vs. 14%, P < .001), corticosteroids (100% vs. 96%, P = .007) and prone position in both awake (42% vs. 28%, P = .012), and intubated patients (67% vs. 54%, P = .034). The days of IMV, ICU stay and hospital stay were lower in period 2. Mortality was similar in the two periods studied (16% vs. 17%). Conclusions: After one year of pandemic, we observed that in patients admitted to the ICU, CNAF, NIMV, use of the prone position, and corticosteroids have been used more frequently, reducing the number of patients in IMV, and the length of stay in the ICU and hospital stay. Mortality was similar in the two study periods.