With the spread of COVID-19 epidemic since 2019 in Wuhan, China health plans have to be adapted continuously in response to the emergency. The first publications from the Chinese experience demonstrate an increase in the incidence of COVID-19 infections in patients over 60 years of age, a higher frequency of severe forms of the disease and therefore theoretical indications of orientation towards resuscitative care. However, the first published data from Hubei province suggest a low benefit of resuscitation for patients between 70 and 80 years of age and null in patients over 80 years of age. These data question the individual benefit / risk balance of an orientation towards resuscitation for this category of patients, their quality of life and the concept of unreasonable obstinacy. Among the covariates associated with resuscitation mortality described in the data published to date, cardiovascular comorbidities, certain biological covariates (LDH, creatinine, lymphocytes, neutrophils, TP, D-dimers, etc.), the time between the first symptoms and the entry into resuscitation have been identified. The objective of this multicentric observational study is to determine the clinical and biological covariates predictive of mortality in the population of patients over 60 years of age admitted in intensive care unit, in particular by integrating functional and nutritional data from patients 1 month before COVID-19 infection.
Other: Group1
Comorbidities (CIRS-G scale),
Functional status of the patient with
Clinical frailty scale (1 month before infection)
ADL score (1 month before infection)
Biological data
Blood group
TP, D-dimers, CRP, creatinine level at the patient's entry, triglyceridemia, fibrinogen, ferritin
Parameters derived from the platelet formula count on D1 of the start of intensive care (lymphocytes, neutrophils, platelets, average platelet volume, red blood cell distribution index), SYSMEX data (IG: Immature granulocytes; HFLC: high fluorescent lymphocyte count)
Resuscitation outcomes
LDH rate at the start of intensive care
PaO2 / FiO2 ratio at the start of intensive care
IGSII / SASPII score (simplified acute physiology score) on D1 of the start of intensive care
SOFA score (sepsis-related organ failure assessment): a posteriori estimate based on IGSII / SASPII
Delay between the appearance of the first signs of infection and admission to intensive care
Inclusion Criteria:
- Patient over 60
- sent to the intensive care unit
- whose COVID diagnosis has been established (RT-PCR and / or chest scanner)
Exclusion Criteria:
- Refusal of the patient or his support person to participate in the study
Resuscitation unit at Hospital Emile Roux
Le Puy-en-Velay, France
- Resuscitation unit of the Groupement Hospitalier Nord - Hospices Civils de Lyon
Lyon, France
- Resuscitation unit of the Groupement Hospitalier Sud - Hospices Civils de Lyon
Lyon, France
Resuscitation unit of the Groupement Hospitalier Centre - Hospices Civils de Lyon
Lyon, France
Resuscitation unit of the Groupement Hospitalier Sud - Hospices Civils de Lyon
Lyon, France
Service de Réanimation de l'Hôpital Nord Ouest
Villefranche-sur-Saône, France
Medipole Resuscitation unit
Villeurbanne, France
Claire Falandry, MD
33 4 78 86 32 87
claire.falandry@chu-lyon.fr
Claire Falandry, MD, Principal Investigator
Hospices Civils de Lyon