What have we learned from the first to the second wave of COVID-19 pandemic? An international survey from the ESCMID Study Group for Infection in the Elderly (ESGIE) group.
What have we learned from the first to the second wave of COVID-19 pandemic? An international survey from the ESCMID Study Group for Infection in the Elderly (ESGIE) group.
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DOI：
10.1007/s10096-021-04377-1
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Falcone M
中科院分区：
文献类型：
--
作者：
Tiseo G;Yahav D;Paul M;Tinelli M;Gavazzi G;Mussini C;Prendki V;Falcone M
本次调查的目的是探索第一波与第二波COVID-19管理的变化，特别强调治疗，抗生素处方和老年人护理。向欧洲临床微生物学和传染病学会（ESCMID）成员分发了一份基于互联网的问卷调查。研究了轻中度（PiO 2/FiO 2 200-350）和重度（PiO 2/FiO 2 < 200）COVID-19患者的治疗方法、抗生素使用情况以及将患者排除出重症监护室（ICU）的原因。共有来自21个国家的463人参加了这项研究。代表以传染病专科医生为主（68.3%）。在第二波大流行期间，医生放弃使用羟氯喹、洛匹那韦/利托那韦和阿奇霉素，转而使用地塞米松、低分子量肝素（LMWH）和瑞德西韦治疗轻中度COVID-19。在重症患者中，我们发现高剂量类固醇的使用增加（51%），托珠单抗的使用减少。在第二波中，住院时抗生素的使用有所减少，但仍然很高。据报道，年龄是25%的应答者将患者排除在ICU护理之外的主要考虑因素;三分之一的应答者报告称，老年人不是他们中心ICU入院的候选人。在59.6%的病例中，将患者从ICU护理中排除的决定是基于重症监护医师的个人决定。随着证据的积累和指南的制定，医生对COVID-19的态度随着时间的推移而改变。入院时抗生素的使用和将患者排除在ICU护理之外的决定仍然是临床医生应该更好地调查和协调的关键方面。在线版本包含补充材料，可通过10.1007/s10096-021-04377-1获得。
The purpose of this survey is to explore changes in the management of COVID-19 during the first versus the second wave, with particular emphasis on therapies, antibiotic prescriptions, and elderly care. An internet-based questionnaire survey was distributed to European Society of Clinical Microbiology and Infectious Diseases (ESCMID) members. Therapeutic approach to patients with mild-to-moderate (PiO2/FiO2 200–350) and severe (PiO2/FiO2 < 200) COVID-19, antibiotic use, and reasons for excluding patients from the intensive care unit (ICU) were investigated. A total of 463 from 21 countries participated in the study. Most representatives were infectious disease specialists (68.3%). During the second wave of pandemic, physicians abandoned the use of hydroxychloroquine, lopinavir/ritonavir, and azithromycin in favor of dexamethasone, low-molecular weight heparin (LMWH), and remdesivir in mild-to-moderate COVID-19. In critically ill patients, we detected an increased use of high-dose steroids (51%) and a decrease in tocilizumab use. The use of antibiotics at hospital admission decreased but remained high in the second wave. Age was reported to be a main consideration for exclusion of patients from ICU care by 25% of responders; a third reported that elderly were not candidates for ICU admission in their center. The decision to exclude patients from ICU care was based on the individual decision of an intensivist in 59.6% of cases. The approach of physicians to COVID-19 changed over time following evidence accumulation and guidelines. Antibiotic use at hospital admission and decision to exclude patients from ICU care remain critical aspects that should be better investigated and harmonized among clinicians. The online version contains supplementary material available at 10.1007/s10096-021-04377-1.
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DOI：
10.1186/s13054-020-03449-6
发表时间：
2021-01-04
期刊：
Critical care (London, England)
影响因子：
--
作者：
Contou D;Fraissé M;Pajot O;Tirolien JA;Mentec H;Plantefève G
通讯作者：
Plantefève G
影响因子：
4.2
作者：
Falcone M;Tiseo G;Barbieri G;Galfo V;Russo A;Virdis A;Forfori F;Corradi F;Guarracino F;Carrozzi L;Celi A;Santini M;Monzani F;De Marco S;Pistello M;Danesi R;Ghiadoni L;Farcomeni A;Menichetti F;Pisa COVID-19 Study Group
通讯作者：
Pisa COVID-19 Study Group
DOI：
10.1016/j.cmi.2020.07.016
发表时间：
2020-12
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Langford BJ;So M;Raybardhan S;Leung V;Westwood D;MacFadden DR;Soucy JR;Daneman N
通讯作者：
Daneman N
DOI：
10.1016/j.cmi.2020.12.011
发表时间：
2021-03
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Mussini C;Falcone M;Nozza S;Sagnelli C;Parrella R;Meschiari M;Petrosillo N;Mastroianni C;Cascio A;Iaria C;Galli M;Chirianni A;Sagnelli E;Iacobello C;Di Perri G;Mazzotta F;Carosi G;Tinelli M;Grossi P;Armignacco O;Portelli V;Andreoni M;Tavio M;Italian Society of Infectious and Tropical Diseases
通讯作者：
Italian Society of Infectious and Tropical Diseases
影响因子：
15.1
作者：
Azoulay, Elie;de Waele, Jan;Cecconi, Maurizio
通讯作者：
Cecconi, Maurizio