From: Clinical sepsis phenotypes in critically ill COVID-19 patients
Parameters obtained within 24 h of ICU admission | COVID-19 pre-dexamethasone (n = 2288) | COVID-19 post-dexamethasone (n = 8596) | non-COVID-19 viral pneumonia (n = 3460) | Bacterial pneumonia (n = 19,947) | Sepsis of non-pulmonary origin (n = 17,983) |
---|---|---|---|---|---|
Jan 2020–Apr 2020 | Sep 2020–Nov 2021 | Jan 2016–Sep 2019 | Jan 2016–Sep 2019 | Jan 2016–Sep 2019 | |
Sex, male | 1672 (73%) | 5914 (69%)*** | 1823 (53%)*** | 12,147 (61%)*** | 10,373 (58%)*** |
BMI, kg/m2 | 27.8 [25.4—31.2] | 29.2 [26.1—33.0]*** | 25.7 [22.6—29.7]*** | 25.2 [22.4—29.1]*** | 26.2 [23.2—30.3]*** |
Normal (< 25) | 490 (21%) | 1487 (17%)*** | 1516 (44%)*** | 9262 (46%)*** | 7037 (39%)*** |
Overweight (25 to < 30) | 1032 (45%) | 3281 (38%)*** | 1012 (29%)*** | 5957 (30%)*** | 5699 (32%)*** |
Obese Class 1: (30 to < 35) | 481 (21%) | 2261 (26%)*** | 464 (13%)*** | 2406 (12%)*** | 2631 (15%)*** |
Class 2: (35 to < 40) | 161 (7%) | 951 (11%)*** | 203 (6%) | 947 (5%)*** | 1082 (6%) |
Class 3: (> 40) | 89 (4%) | 508 (6%)*** | 148 (4%) | 636 (3%) | 821 (5%) |
Age, years | 65 [56—72] | 64 [55—71]* | 66 [57—74]*** | 69 [60—77]*** | 69 [59—77]*** |
APACHE IV score | 58 [47—71] | 59 [49—71] | 64 [51—80]*** | 73 [58—91]*** | 78 [62—98]*** |
APACHE IV APSa score | 46 [38—57] | 48 [40—58]* | 50 [39—65]*** | 57 [44—74]*** | 62 [47—81]*** |
Aids | 1 (0%) | 7 (0%) | 6 (0%) | 87 (0%)* | 42 (0%) |
Cardiovascular insuffiency | 23 (1%) | 117 (1%) | 115 (3%)*** | 877 (4%)*** | 754 (4%)*** |
Chronic dialysis | 3 (0%) | 53 (1%)* | 33 (1%)*** | 244 (1%)*** | 471 (3%)*** |
Chronic renal insuffiency | 60 (3%) | 377 (4%)*** | 237 (7%)*** | 1769 (9%)*** | 2389 (13%)*** |
Cirrhosis | 3 (0%) | 40 (0%) | 22 (1%)* | 286 (1%)*** | 542 (3%)*** |
COPD | 183 (8%) | 809 (9%) | 1551 (45%)*** | 6605 (33%)*** | 2248 (13%)*** |
Diabetes mellitus | 435 (19%) | 2050 (24%)*** | 693 (20%) | 4186 (21%) | 4696 (26%)*** |
Hematological malignancy | 35 (2%) | 138 (2%) | 180 (5%)*** | 1030 (5%)*** | 995 (6%)*** |
Immunological insufficiency | 167 (7%) | 776 (9%)* | 640 (18%)*** | 3683 (18%)*** | 3467 (19%)*** |
Metastatic neoplasm | 16 (1%) | 55 (1%) | 68 (2%)*** | 1054 (5%)*** | 1280 (7%)*** |
Respiratory insufficiency | 92 (4%) | 361 (4%) | 594 (17%)*** | 2336 (12%)*** | 581 (3%) |
Comorbidity indexb | 0.44 (0.014) | 0.55 (0.008)*** | 0.88 (0.014)*** | 0.84 (0.006)*** | 0.70 (0.007)*** |
Mechanical ventilation | 1848 (81%) | 5030 (59%)*** | 2449 (71%)*** | 11,321 (57%)*** | 5323 (30%)*** |
PaO2 (mmHg) | 77 (66—94) | 70 (60—83)*** | 74 (64—89)*** | 75 (64—90)*** | 82 (70—99)*** |
PaO2/FiO2 ratio | 125 [90—173] | 90 [69—124]*** | 167 [112—233]*** | 149 [98—221]*** | 257 [164—344]*** |
No ARDS (> 300 mmHg) | 100 (4%) | 176 (2%)*** | 316 (9%)*** | 1657 (8%)*** | 5352 (30%)*** |
Mild ARDS (> 200–≤ 300 mmHg) | 238 (10%) | 372 (4%)*** | 792 (23%)*** | 3617 (18%)*** | 4053 (23%)*** |
Moderate ARDS (> 100–≤ 200 mmHg) | 1058 (46%) | 2575 (30%)*** | 1315 (38%)*** | 7216 (36%)*** | 3647 (20%)*** |
Severe ARDS (≤ 100 mmHg) | 684 (30%) | 4645 (54%)*** | 623 (18%)*** | 4512 (23%)*** | 1366 (8%)*** |
PaCO2, mmHg | 41 [35—48] | 36 [32—43]*** | 47 [37—60]*** | 41 [33—52] | 34 [29—40]*** |
Respiratory rate (max), breaths/min | 31 [26—38] | 33 [28—39]*** | 32 [27—39]*** | 32 [27—38]*** | 30 [25—35]*** |
Vasoactive medication | 1569 (69%) | 3945 (46%)*** | 1541 (45%)*** | 9872 (49%)*** | 12,140 (68%) |
Hematocrit (min) | 0.37 [0.34—0.39] | 0.38 [0.35—0.41]*** | 0.37 [0.32—0.41] | 0.34 [0.29—0.38]*** | 0.31 [0.27—0.35]*** |
Heart rate (max), beats/min | 103 [91—116] | 98 [87—112]*** | 116 [101—132]*** | 118 [102—135]*** | 116 [100—135]*** |
Mean arterial pressure (min), mmHg | 62 [57—68] | 66 [59—73]*** | 61 [54—69]** | 59 [52—67]*** | 55 [48—62]*** |
Mean arterial pressure (max), mmHg | 107 [97—121] | 108 [98—121] | 106 [94—121]** | 100 [89—114]*** | 94 [84—106]*** |
Acute renal failure | 204 (9%) | 493 (6%)*** | 402 (12%)** | 3650 (18%)*** | 6283 (35%)*** |
Creatinine, max, µmol/L | 78 [63—102] | 73 [60—98]** | 84 [60—127]*** | 97 [67—156]*** | 146 [93—237]*** |
Blood urea nitrogen, mg/dL | 18 [13—25] | 23 [17—31]*** | 23 [15—35]*** | 28 [18—43]*** | 35 [22—54]*** |
Urinary output, L | 1.20 [0.82—1.72] | 1.60 [1.19—2.20]*** | 1.53 [1.00—2.23]*** | 1.48 [0.92—2.23]*** | 1.35 [0.66—2.20]*** |
Bilirubin, µmol/L | 9 [6—12] | 8 [6—12]*** | 8 [5—12]*** | 10 [6—16]*** | 14 [8—27]*** |
Sodium, max, mmol/L | 138 [136—141] | 139 [137—141]*** | 139 [136—142]*** | 139 [136—142]*** | 139 [136—142]*** |
Potassium (max), mmol/L | 4.1 [3.8—4.4] | 4.3 [4.0—4.6]*** | 4.4 [4.0—4.8]*** | 4.3 [4.0—4.8]*** | 4.3 [4.0—4.9]*** |
Glucose (max), mmol/L | 8.4 [7.1—10.9] | 11.5 [9.2—15.2]*** | 9.9 [7.9—12.5]*** | 9.5 [7.5—12.5]*** | 9.0 [7.1—12.1]*** |
pH (min) | 7.39 [7.32—7.45] | 7.44 [7.38—7.48]*** | 7.36 [7.29—7.43]*** | 7.38 [7.29—7.44]*** | 7.38 [7.30—7.44]*** |
Bicarbonate (max), mmol/L | 26 [24—28] | 26 [24—28] | 28 [24—32]*** | 25 [22—29]*** | 22 [19—24]*** |
Albumin (min), g/L | 26 [23—30] | 28 [25—32]*** | 29 [25—34]*** | 26 [22—31] | 24 [20—28]*** |
White blood cell count (max), × 109/L | 9.1 [6.9—12.0] | 9.9 [7.2—13.2]*** | 11.0 [7.5—15.3]*** | 13.8 [9.4—19.6]*** | 15.9 [10.2—23.4]*** |
Thrombocytes (min), × 109/L | 228 [172—296] | 240 [185—305]*** | 198 [143—261]*** | 208 [148—285]*** | 169 [104—254]*** |
Temperature, °C | 38.7 [38.0—39.4] | 37.5 [37.0—38.2]*** | 38.1 [37.4—38.8]*** | 38.0 [37.4—38.8]*** | 38.0 [37.3—38.9]*** |
Outcome parameters | |||||
ICU length-of-stay survivors, days | 15 [9—29] | 8 [4—17]*** | 4 [2—8]*** | 3 [2—7]*** | 2 [1–5]*** |
ICU length-of-stay non-survivors, days | 11 [5—21] | 16 [8—25]*** | 6 [2—12]*** | 3 [1—8]*** | 2 [1–5]*** |
ICU mortality | 609 (27%) | 1965 (23%)*** | 583 (17%)*** | 3831 (19%)*** | 3250 (18%)*** |
Hospital length-of-stay survivors, days | 29 [18—45] | 19 [12—33]*** | 11 [7—20]*** | 13 [8—22]*** | 13 [7—24]*** |
Hospital length-of-stay non-survivors, days | 15 [8—24] | 20 [12—30]*** | 9 [4—17]*** | 8 [3—16]*** | 7 [2—17]*** |
In-hospital mortality | 666 (29%) | 2181 (25%)** | 755 (22%)*** | 5257 (26%)* | 4456 (25%)*** |
28-day in-hospital mortality | 554 (24%) | 1588 (18%)*** | 676 (20%)*** | 4705 (24%) | 3932 (22%) |
90-day in-hospital mortality | 664 (29%) | 2168 (25%)** | 753 (22%)*** | 5228 (26%)* | 4407 (25%)*** |