Show simple item record

dc.contributor.authorBruno, Raphael Romano
dc.contributor.authorWernley, Bernhard
dc.contributor.authorFlaatten, Hans
dc.contributor.authorFjølner, Jesper
dc.contributor.authorArtigas, Antonio
dc.contributor.authorPinto, Bernardo Bollen
dc.contributor.authorSchefold, Joerg C.
dc.contributor.authorBinnebössel, Stephan
dc.contributor.authorBaldia, Philipp Heinrich
dc.contributor.authorKelm, Malte
dc.contributor.authorBeil, Michael
dc.contributor.authorSigal, Sivri
dc.contributor.authorvan Heerden, Peter Vernon
dc.contributor.authorSzczeklik, Wojciech
dc.contributor.authorElhadi, Muhammed
dc.contributor.authorJoannidis, Michael
dc.contributor.authorOeyen, Sandra
dc.contributor.authorZafeiridis, Tilemachos
dc.contributor.authorWollborn, Jakob
dc.contributor.authorBanzo, Maria José Arche
dc.contributor.authorFuest, Kristina
dc.contributor.authorMarsh, Brian
dc.contributor.authorAndersen, Finn H.
dc.contributor.authorMoreno, Rui
dc.contributor.authorLeaver, Susannah
dc.contributor.authorBoumendil, Ariane
dc.contributor.authorDe Lange, Dylan W.
dc.contributor.authorGuidet, Bertrand
dc.contributor.authorJung, Christian
dc.description.abstractPurpose: Lactate is an established prognosticator in critical care. However, there still is insufficient evidence about its role in predicting outcome in COVID-19. This is of particular concern in older patients who have been mostly affected during the initial surge in 2020. Methods: This prospective international observation study (The COVIP study) recruited patients aged 70 years or older ( ID: NCT04321265) admitted to an intensive care unit (ICU) with COVID-19 disease from March 2020 to February 2021. In addition to serial lactate values (arterial blood gas analysis), we recorded several parameters, including SOFA score, ICU procedures, limitation of care, ICU- and 3-month mortality. A lactate concentration ≥ 2.0 mmol/L on the day of ICU admission (baseline) was defined as abnormal. The primary outcome was ICU-mortality. The secondary outcomes 30-day and 3-month mortality. Results: In total, data from 2860 patients were analyzed. In most patients (68%), serum lactate was lower than 2 mmol/L. Elevated baseline serum lactate was associated with significantly higher ICU- and 3-month mortality (53% vs. 43%, and 71% vs. 57%, respectively, p < 0.001). In the multivariable analysis, the maximum lactate concentration on day 1 was independently associated with ICU mortality (aOR 1.06 95% CI 1.02–1.11; p = 0.007), 30-day mortality (aOR 1.07 95% CI 1.02–1.13; p = 0.005) and 3-month mortality (aOR 1.15 95% CI 1.08–1.24; p < 0.001) after adjustment for age, gender, SOFA score, and frailty. In 826 patients with baseline lactate ≥ 2 mmol/L sufficient data to calculate the difference between maximal levels on days 1 and 2 (∆ serum lactate) were available. A decreasing lactate concentration over time was inversely associated with ICU mortality after multivariate adjustment for SOFA score, age, Clinical Frailty Scale, and gender (aOR 0.60 95% CI 0.42–0.85; p = 0.004). Conclusion: In critically ill old intensive care patients suffering from COVID-19, lactate and its kinetics are valuable tools for outcome prediction.en_US
dc.rightsNavngivelse 4.0 Internasjonal*
dc.titleLactate is associated with mortality in very old intensive care patients suffering from COVID-19: results from an international observational study of 2860 patientsen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.rights.holderCopyright 2021 the authorsen_US
dc.source.journalAnnals of Intensive Careen_US
dc.identifier.citationAnnals of Intensive Care. 2021, 11, 128.en_US

Files in this item


This item appears in the following Collection(s)

Show simple item record

Navngivelse 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Navngivelse 4.0 Internasjonal