Epidemiology, Ventilation Management, and Outcomes in Invasively Ventilated Coronavirus Disease 2019 Patients: An Analysis of Four Observational Studies in Four Countries on Two Continents
Issued Date
2025-04-01
Resource Type
ISSN
00029637
eISSN
14761645
Scopus ID
2-s2.0-105002592903
Pubmed ID
39842032
Journal Title
American Journal of Tropical Medicine and Hygiene
Volume
112
Issue
4
Start Page
875
End Page
882
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene Vol.112 No.4 (2025) , 875-882
Suggested Citation
Blok S.G., Pisani L., Estenssoro E., Ferreira J.C., Botta M., Motos A., Martin-Loeches I., Torres A., Schultz M.J., Paulus F., van Meenen D.M.P. Epidemiology, Ventilation Management, and Outcomes in Invasively Ventilated Coronavirus Disease 2019 Patients: An Analysis of Four Observational Studies in Four Countries on Two Continents. American Journal of Tropical Medicine and Hygiene Vol.112 No.4 (2025) , 875-882. 882. doi:10.4269/ajtmh.24-0257 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/109646
Title
Epidemiology, Ventilation Management, and Outcomes in Invasively Ventilated Coronavirus Disease 2019 Patients: An Analysis of Four Observational Studies in Four Countries on Two Continents
Author's Affiliation
Mahidol Oxford Tropical Medicine Research Unit
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Hospital Interzonal General de Agudos de La Plata
Hospital Clínic de Barcelona
Medizinische Universität Wien
Nuffield Department of Medicine
Universidade de São Paulo
St James's Hospital
Amsterdam UMC - University of Amsterdam
University of Applied Science
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Hospital Interzonal General de Agudos de La Plata
Hospital Clínic de Barcelona
Medizinische Universität Wien
Nuffield Department of Medicine
Universidade de São Paulo
St James's Hospital
Amsterdam UMC - University of Amsterdam
University of Applied Science
Corresponding Author(s)
Other Contributor(s)
Abstract
Epidemiology, ventilator management, and outcomes in patients with acute respiratory distress syndrome (ARDS) because of coronavirus disease 2019 (COVID-19) have been described extensively but have never been compared between countries. We performed an individual patient data analysis of four observational studies to compare epidemiology, ventilator management, and outcomes. We used propensity score weighting to control for confounding factors. The analysis included 6,702 patients: 1,500 from Argentina, 844 from Brazil, 975 from the Netherlands, and 3,383 from Spain. There were substantial differences in baseline characteristics between countries. There were small differences in ventilation management. Intensive care unit mortality was higher in Argentina and Brazil compared with the Netherlands and Spain (59.6% and 56.6% versus 32.1% and 34.7%; P,0.001). The median number of days free from ventilation and alive at day 28 was equally low (0 [0-7], 0 [0-18], 1 [0-16], and 0 [0-16] days, respectively; P 5 0.03), and the median number of days free from ventilation and alive at day 60 was higher in the Netherlands and Spain (0 [0-37], 0 [0-50], 33 [0-48], and 26 [0-48] days, respectively; P,0.001). Propensity score matching confirmed the outcome differences. Thus, the outcome of COVID-19 ARDS patients in Argentina and Brazil was substantially worse compared with that of patients in the Netherlands and Spain. It is unlikely that this results from differences in case mix or ventilation management.