Loading…

Characteristics and outcomes of acute respiratory distress syndrome related to COVID-19 in Belgian and French intensive care units according to antiviral strategies: the COVADIS multicentre observational study

Background Limited data are available regarding antiviral therapy efficacy in most severe patients under mechanical ventilation for Covid-19-related acute respiratory distress syndrome (ARDS). Methods Comparison of antiviral strategies (none, hydroxychloroquine (OHQ), lopinavir/ritonavir (L/R), othe...

Full description

Saved in:
Bibliographic Details
Published in:Annals of intensive care 2020-10, Vol.10 (1), p.131-11, Article 131
Main Authors: Grimaldi, David, Aissaoui, Nadia, Blonz, Gauthier, Carbutti, Giuseppe, Courcelle, Romain, Gaudry, Stephane, Gaultier, Aurelie, D’hondt, Alain, Higny, Julien, Horlait, Geoffrey, Hraiech, Sami, Lefebvre, Laurent, Lejeune, Francois, Ly, Andre, Piagnerelli, Michael, Sauneuf, Bertrand, Serck, Nicolas, Soumagne, Thibaud, Szychowiak, Piotr, Textoris, Julien, Vandenbunder, Benoit, Vinsonneau, Christophe, Lascarrou, Jean- Baptiste
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c613t-50850794cceb6ca6ec86c68305375c8f154fdd6ce79e1abb54126394c60f98923
cites cdi_FETCH-LOGICAL-c613t-50850794cceb6ca6ec86c68305375c8f154fdd6ce79e1abb54126394c60f98923
container_end_page 11
container_issue 1
container_start_page 131
container_title Annals of intensive care
container_volume 10
creator Grimaldi, David
Aissaoui, Nadia
Blonz, Gauthier
Carbutti, Giuseppe
Courcelle, Romain
Gaudry, Stephane
Gaultier, Aurelie
D’hondt, Alain
Higny, Julien
Horlait, Geoffrey
Hraiech, Sami
Lefebvre, Laurent
Lejeune, Francois
Ly, Andre
Piagnerelli, Michael
Sauneuf, Bertrand
Serck, Nicolas
Soumagne, Thibaud
Szychowiak, Piotr
Textoris, Julien
Vandenbunder, Benoit
Vinsonneau, Christophe
Lascarrou, Jean- Baptiste
description Background Limited data are available regarding antiviral therapy efficacy in most severe patients under mechanical ventilation for Covid-19-related acute respiratory distress syndrome (ARDS). Methods Comparison of antiviral strategies (none, hydroxychloroquine (OHQ), lopinavir/ritonavir (L/R), others (combination or remdesivir) in an observational multicentre cohort of patients with moderate-to-severe Covid-19 ARDS. The primary endpoint was the number of day 28 ventilator-free days (VFD). Patients who died before d28 were considered as having 0 VFD. The variable was dichotomized into “patients still ventilated or dead at day 28” versus “patients weaned and alive at day 28”. Results We analyzed 415 patients (85 treated with standard of care (SOC), 57 with L/R, 220 with OHQ, and 53 others). The median number of d28-VFD was 0 (IQR 0–13) and differed between groups ( P  = 0.03), SOC patients having the highest d28-VFD. After adjustment for age, sex, Charlson Comorbidity Index, PaO 2 /FiO 2 ratio and plateau pressure and accounting for center effect with a generalized linear mixed model, none of the antiviral strategies increased the chance of being alive and weaned from MV at day 28 compared to the SOC strategy (OR 0.48 CI95% (0.18–1.25); OR 0.96 (0.47–2.02) and OR 1.43 (0.53–4.04) for L/R, OHQ and other treatments, respectively). Acute kidney injury during ICU stay was frequent (55%); its incidence was higher in patients receiving lopinavir (66 vs 53%, P  = 0.03). After adjustment for age, sex, BMI, chronic hypertension and chronic renal disease, the use of L/R was associated with an increased risk of renal replacement therapy (RRT). (OR 2.52 CI95% 1.16–5.59). Conclusion In this multicentre observational study of moderate-to-severe Covid-19 ARDS patients, we did not observe any benefit among patients treated with OHQ or L/R compared with SOC. The use of L/R treatment was associated with an increased need for RRT. Take home message Neither hydroxychloroquine nor lopinavir/ritonavir as COVID-19 antiviral treatment is associated with higher ventilator-free days at day 28 when compared with standard of care (no antiviral treatment) in ICU patients under invasive mechanical ventilation. Lopinavir/ritonavir is associated with an increased risk of renal replacement therapy requirement. Tweet COVID-19: Insights from ARDS cohort: no signal of efficacy of any antiviral drugs. Lopinavir/ritonavir may be associated with need for RRT
doi_str_mv 10.1186/s13613-020-00751-y
format article
fullrecord <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_4f559f56b3bc4e7f91d7e93bc9d0b06d</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_4f559f56b3bc4e7f91d7e93bc9d0b06d</doaj_id><sourcerecordid>2449181895</sourcerecordid><originalsourceid>FETCH-LOGICAL-c613t-50850794cceb6ca6ec86c68305375c8f154fdd6ce79e1abb54126394c60f98923</originalsourceid><addsrcrecordid>eNp9ks9u1DAQxiMEolXpC3BAPsIhYCdxEnNAWraUrlSpB_5cLceeZL3K2ovtrLSPyRsxuylVywFfYs9885ux82XZa0bfM9bWHyIra1bmtKA5pQ1n-eFZdl4wRnPeFvT5o_1ZdhnjhuLitCmK8mV2Vpa04EXBz7Pfy7UKSicINiarI1HOED8l7bcQie-J0lMCEiDubFDJhwMxqMRzJPHgTEAdZkeVwJDkyfLu5-oqZ4JYRz7DOFjlTsjrAE6vMZrARbsHolUAMjmbsKXWPhjrhiNAuWT32Gok2AWpg4X4kaQ1HNGLq9U3sp1GnBQcDkF8FyHsVbLenSomc3iVvejVGOHy_nuR_bj-8n15k9_efV0tF7e5xndLOactPoeotIau1qoG3da6bkvKy4brtme86o2pNTQCmOo6XrGiLlFf0160oigvstXMNV5t5C7YrQoH6ZWVp4APg1QBBx1BVj3noud1V3a6gqYXzDQg8CAM7WhtkPVpZu2mbgvmdDk1PoE-zTi7loPfywanFQ1DwLsZsP6n7GZxK48xWtYV5aLaH7Vv75sF_2uCmOTWRg3jqBz4KcqiqgRrWSs4SotZqoOPMUD_wGZUHm0oZxtKtKE82VAesOjN48s8lPw1HQrKWRAx5QYIcuOngD8w_g_7B9Z47Yw</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2449181895</pqid></control><display><type>article</type><title>Characteristics and outcomes of acute respiratory distress syndrome related to COVID-19 in Belgian and French intensive care units according to antiviral strategies: the COVADIS multicentre observational study</title><source>PubMed Central(OpenAccess)</source><source>Springer Nature - SpringerLink Journals - Fully Open Access</source><source>ProQuest Publicly Available Content database</source><creator>Grimaldi, David ; Aissaoui, Nadia ; Blonz, Gauthier ; Carbutti, Giuseppe ; Courcelle, Romain ; Gaudry, Stephane ; Gaultier, Aurelie ; D’hondt, Alain ; Higny, Julien ; Horlait, Geoffrey ; Hraiech, Sami ; Lefebvre, Laurent ; Lejeune, Francois ; Ly, Andre ; Piagnerelli, Michael ; Sauneuf, Bertrand ; Serck, Nicolas ; Soumagne, Thibaud ; Szychowiak, Piotr ; Textoris, Julien ; Vandenbunder, Benoit ; Vinsonneau, Christophe ; Lascarrou, Jean- Baptiste</creator><creatorcontrib>Grimaldi, David ; Aissaoui, Nadia ; Blonz, Gauthier ; Carbutti, Giuseppe ; Courcelle, Romain ; Gaudry, Stephane ; Gaultier, Aurelie ; D’hondt, Alain ; Higny, Julien ; Horlait, Geoffrey ; Hraiech, Sami ; Lefebvre, Laurent ; Lejeune, Francois ; Ly, Andre ; Piagnerelli, Michael ; Sauneuf, Bertrand ; Serck, Nicolas ; Soumagne, Thibaud ; Szychowiak, Piotr ; Textoris, Julien ; Vandenbunder, Benoit ; Vinsonneau, Christophe ; Lascarrou, Jean- Baptiste ; COVADIS study group ; for the COVADIS study group</creatorcontrib><description>Background Limited data are available regarding antiviral therapy efficacy in most severe patients under mechanical ventilation for Covid-19-related acute respiratory distress syndrome (ARDS). Methods Comparison of antiviral strategies (none, hydroxychloroquine (OHQ), lopinavir/ritonavir (L/R), others (combination or remdesivir) in an observational multicentre cohort of patients with moderate-to-severe Covid-19 ARDS. The primary endpoint was the number of day 28 ventilator-free days (VFD). Patients who died before d28 were considered as having 0 VFD. The variable was dichotomized into “patients still ventilated or dead at day 28” versus “patients weaned and alive at day 28”. Results We analyzed 415 patients (85 treated with standard of care (SOC), 57 with L/R, 220 with OHQ, and 53 others). The median number of d28-VFD was 0 (IQR 0–13) and differed between groups ( P  = 0.03), SOC patients having the highest d28-VFD. After adjustment for age, sex, Charlson Comorbidity Index, PaO 2 /FiO 2 ratio and plateau pressure and accounting for center effect with a generalized linear mixed model, none of the antiviral strategies increased the chance of being alive and weaned from MV at day 28 compared to the SOC strategy (OR 0.48 CI95% (0.18–1.25); OR 0.96 (0.47–2.02) and OR 1.43 (0.53–4.04) for L/R, OHQ and other treatments, respectively). Acute kidney injury during ICU stay was frequent (55%); its incidence was higher in patients receiving lopinavir (66 vs 53%, P  = 0.03). After adjustment for age, sex, BMI, chronic hypertension and chronic renal disease, the use of L/R was associated with an increased risk of renal replacement therapy (RRT). (OR 2.52 CI95% 1.16–5.59). Conclusion In this multicentre observational study of moderate-to-severe Covid-19 ARDS patients, we did not observe any benefit among patients treated with OHQ or L/R compared with SOC. The use of L/R treatment was associated with an increased need for RRT. Take home message Neither hydroxychloroquine nor lopinavir/ritonavir as COVID-19 antiviral treatment is associated with higher ventilator-free days at day 28 when compared with standard of care (no antiviral treatment) in ICU patients under invasive mechanical ventilation. Lopinavir/ritonavir is associated with an increased risk of renal replacement therapy requirement. Tweet COVID-19: Insights from ARDS cohort: no signal of efficacy of any antiviral drugs. Lopinavir/ritonavir may be associated with need for RRT</description><identifier>ISSN: 2110-5820</identifier><identifier>EISSN: 2110-5820</identifier><identifier>DOI: 10.1186/s13613-020-00751-y</identifier><identifier>PMID: 33025225</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Acute kidney injury ; Anesthesiology ; Critical Care Medicine ; Emergency Medicine ; Emerging diseases ; Human health and pathology ; Hydroxychloroquine ; Infectious diseases ; Intensive ; Life Sciences ; Lopinavir ; Medicine ; Medicine &amp; Public Health ; Pharmaceutical sciences ; Pharmacology ; Pulmonology and respiratory tract ; Remdesivir ; Renal replacement therapy ; Ritonavir ; Santé publique et épidémiologie</subject><ispartof>Annals of intensive care, 2020-10, Vol.10 (1), p.131-11, Article 131</ispartof><rights>The Author(s) 2020</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c613t-50850794cceb6ca6ec86c68305375c8f154fdd6ce79e1abb54126394c60f98923</citedby><cites>FETCH-LOGICAL-c613t-50850794cceb6ca6ec86c68305375c8f154fdd6ce79e1abb54126394c60f98923</cites><orcidid>0000-0001-8428-065X ; 0000-0002-8266-1210 ; 0000-0002-3821-9337 ; 0000-0003-3706-078X ; 0000-0001-5123-9538</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7537971/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7537971/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,37013,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33025225$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03640594$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Grimaldi, David</creatorcontrib><creatorcontrib>Aissaoui, Nadia</creatorcontrib><creatorcontrib>Blonz, Gauthier</creatorcontrib><creatorcontrib>Carbutti, Giuseppe</creatorcontrib><creatorcontrib>Courcelle, Romain</creatorcontrib><creatorcontrib>Gaudry, Stephane</creatorcontrib><creatorcontrib>Gaultier, Aurelie</creatorcontrib><creatorcontrib>D’hondt, Alain</creatorcontrib><creatorcontrib>Higny, Julien</creatorcontrib><creatorcontrib>Horlait, Geoffrey</creatorcontrib><creatorcontrib>Hraiech, Sami</creatorcontrib><creatorcontrib>Lefebvre, Laurent</creatorcontrib><creatorcontrib>Lejeune, Francois</creatorcontrib><creatorcontrib>Ly, Andre</creatorcontrib><creatorcontrib>Piagnerelli, Michael</creatorcontrib><creatorcontrib>Sauneuf, Bertrand</creatorcontrib><creatorcontrib>Serck, Nicolas</creatorcontrib><creatorcontrib>Soumagne, Thibaud</creatorcontrib><creatorcontrib>Szychowiak, Piotr</creatorcontrib><creatorcontrib>Textoris, Julien</creatorcontrib><creatorcontrib>Vandenbunder, Benoit</creatorcontrib><creatorcontrib>Vinsonneau, Christophe</creatorcontrib><creatorcontrib>Lascarrou, Jean- Baptiste</creatorcontrib><creatorcontrib>COVADIS study group</creatorcontrib><creatorcontrib>for the COVADIS study group</creatorcontrib><title>Characteristics and outcomes of acute respiratory distress syndrome related to COVID-19 in Belgian and French intensive care units according to antiviral strategies: the COVADIS multicentre observational study</title><title>Annals of intensive care</title><addtitle>Ann. Intensive Care</addtitle><addtitle>Ann Intensive Care</addtitle><description>Background Limited data are available regarding antiviral therapy efficacy in most severe patients under mechanical ventilation for Covid-19-related acute respiratory distress syndrome (ARDS). Methods Comparison of antiviral strategies (none, hydroxychloroquine (OHQ), lopinavir/ritonavir (L/R), others (combination or remdesivir) in an observational multicentre cohort of patients with moderate-to-severe Covid-19 ARDS. The primary endpoint was the number of day 28 ventilator-free days (VFD). Patients who died before d28 were considered as having 0 VFD. The variable was dichotomized into “patients still ventilated or dead at day 28” versus “patients weaned and alive at day 28”. Results We analyzed 415 patients (85 treated with standard of care (SOC), 57 with L/R, 220 with OHQ, and 53 others). The median number of d28-VFD was 0 (IQR 0–13) and differed between groups ( P  = 0.03), SOC patients having the highest d28-VFD. After adjustment for age, sex, Charlson Comorbidity Index, PaO 2 /FiO 2 ratio and plateau pressure and accounting for center effect with a generalized linear mixed model, none of the antiviral strategies increased the chance of being alive and weaned from MV at day 28 compared to the SOC strategy (OR 0.48 CI95% (0.18–1.25); OR 0.96 (0.47–2.02) and OR 1.43 (0.53–4.04) for L/R, OHQ and other treatments, respectively). Acute kidney injury during ICU stay was frequent (55%); its incidence was higher in patients receiving lopinavir (66 vs 53%, P  = 0.03). After adjustment for age, sex, BMI, chronic hypertension and chronic renal disease, the use of L/R was associated with an increased risk of renal replacement therapy (RRT). (OR 2.52 CI95% 1.16–5.59). Conclusion In this multicentre observational study of moderate-to-severe Covid-19 ARDS patients, we did not observe any benefit among patients treated with OHQ or L/R compared with SOC. The use of L/R treatment was associated with an increased need for RRT. Take home message Neither hydroxychloroquine nor lopinavir/ritonavir as COVID-19 antiviral treatment is associated with higher ventilator-free days at day 28 when compared with standard of care (no antiviral treatment) in ICU patients under invasive mechanical ventilation. Lopinavir/ritonavir is associated with an increased risk of renal replacement therapy requirement. Tweet COVID-19: Insights from ARDS cohort: no signal of efficacy of any antiviral drugs. Lopinavir/ritonavir may be associated with need for RRT</description><subject>Acute kidney injury</subject><subject>Anesthesiology</subject><subject>Critical Care Medicine</subject><subject>Emergency Medicine</subject><subject>Emerging diseases</subject><subject>Human health and pathology</subject><subject>Hydroxychloroquine</subject><subject>Infectious diseases</subject><subject>Intensive</subject><subject>Life Sciences</subject><subject>Lopinavir</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Pharmaceutical sciences</subject><subject>Pharmacology</subject><subject>Pulmonology and respiratory tract</subject><subject>Remdesivir</subject><subject>Renal replacement therapy</subject><subject>Ritonavir</subject><subject>Santé publique et épidémiologie</subject><issn>2110-5820</issn><issn>2110-5820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNp9ks9u1DAQxiMEolXpC3BAPsIhYCdxEnNAWraUrlSpB_5cLceeZL3K2ovtrLSPyRsxuylVywFfYs9885ux82XZa0bfM9bWHyIra1bmtKA5pQ1n-eFZdl4wRnPeFvT5o_1ZdhnjhuLitCmK8mV2Vpa04EXBz7Pfy7UKSicINiarI1HOED8l7bcQie-J0lMCEiDubFDJhwMxqMRzJPHgTEAdZkeVwJDkyfLu5-oqZ4JYRz7DOFjlTsjrAE6vMZrARbsHolUAMjmbsKXWPhjrhiNAuWT32Gok2AWpg4X4kaQ1HNGLq9U3sp1GnBQcDkF8FyHsVbLenSomc3iVvejVGOHy_nuR_bj-8n15k9_efV0tF7e5xndLOactPoeotIau1qoG3da6bkvKy4brtme86o2pNTQCmOo6XrGiLlFf0160oigvstXMNV5t5C7YrQoH6ZWVp4APg1QBBx1BVj3noud1V3a6gqYXzDQg8CAM7WhtkPVpZu2mbgvmdDk1PoE-zTi7loPfywanFQ1DwLsZsP6n7GZxK48xWtYV5aLaH7Vv75sF_2uCmOTWRg3jqBz4KcqiqgRrWSs4SotZqoOPMUD_wGZUHm0oZxtKtKE82VAesOjN48s8lPw1HQrKWRAx5QYIcuOngD8w_g_7B9Z47Yw</recordid><startdate>20201006</startdate><enddate>20201006</enddate><creator>Grimaldi, David</creator><creator>Aissaoui, Nadia</creator><creator>Blonz, Gauthier</creator><creator>Carbutti, Giuseppe</creator><creator>Courcelle, Romain</creator><creator>Gaudry, Stephane</creator><creator>Gaultier, Aurelie</creator><creator>D’hondt, Alain</creator><creator>Higny, Julien</creator><creator>Horlait, Geoffrey</creator><creator>Hraiech, Sami</creator><creator>Lefebvre, Laurent</creator><creator>Lejeune, Francois</creator><creator>Ly, Andre</creator><creator>Piagnerelli, Michael</creator><creator>Sauneuf, Bertrand</creator><creator>Serck, Nicolas</creator><creator>Soumagne, Thibaud</creator><creator>Szychowiak, Piotr</creator><creator>Textoris, Julien</creator><creator>Vandenbunder, Benoit</creator><creator>Vinsonneau, Christophe</creator><creator>Lascarrou, Jean- Baptiste</creator><general>Springer International Publishing</general><general>SpringerOpen</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-8428-065X</orcidid><orcidid>https://orcid.org/0000-0002-8266-1210</orcidid><orcidid>https://orcid.org/0000-0002-3821-9337</orcidid><orcidid>https://orcid.org/0000-0003-3706-078X</orcidid><orcidid>https://orcid.org/0000-0001-5123-9538</orcidid></search><sort><creationdate>20201006</creationdate><title>Characteristics and outcomes of acute respiratory distress syndrome related to COVID-19 in Belgian and French intensive care units according to antiviral strategies: the COVADIS multicentre observational study</title><author>Grimaldi, David ; Aissaoui, Nadia ; Blonz, Gauthier ; Carbutti, Giuseppe ; Courcelle, Romain ; Gaudry, Stephane ; Gaultier, Aurelie ; D’hondt, Alain ; Higny, Julien ; Horlait, Geoffrey ; Hraiech, Sami ; Lefebvre, Laurent ; Lejeune, Francois ; Ly, Andre ; Piagnerelli, Michael ; Sauneuf, Bertrand ; Serck, Nicolas ; Soumagne, Thibaud ; Szychowiak, Piotr ; Textoris, Julien ; Vandenbunder, Benoit ; Vinsonneau, Christophe ; Lascarrou, Jean- Baptiste</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c613t-50850794cceb6ca6ec86c68305375c8f154fdd6ce79e1abb54126394c60f98923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acute kidney injury</topic><topic>Anesthesiology</topic><topic>Critical Care Medicine</topic><topic>Emergency Medicine</topic><topic>Emerging diseases</topic><topic>Human health and pathology</topic><topic>Hydroxychloroquine</topic><topic>Infectious diseases</topic><topic>Intensive</topic><topic>Life Sciences</topic><topic>Lopinavir</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Pharmaceutical sciences</topic><topic>Pharmacology</topic><topic>Pulmonology and respiratory tract</topic><topic>Remdesivir</topic><topic>Renal replacement therapy</topic><topic>Ritonavir</topic><topic>Santé publique et épidémiologie</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grimaldi, David</creatorcontrib><creatorcontrib>Aissaoui, Nadia</creatorcontrib><creatorcontrib>Blonz, Gauthier</creatorcontrib><creatorcontrib>Carbutti, Giuseppe</creatorcontrib><creatorcontrib>Courcelle, Romain</creatorcontrib><creatorcontrib>Gaudry, Stephane</creatorcontrib><creatorcontrib>Gaultier, Aurelie</creatorcontrib><creatorcontrib>D’hondt, Alain</creatorcontrib><creatorcontrib>Higny, Julien</creatorcontrib><creatorcontrib>Horlait, Geoffrey</creatorcontrib><creatorcontrib>Hraiech, Sami</creatorcontrib><creatorcontrib>Lefebvre, Laurent</creatorcontrib><creatorcontrib>Lejeune, Francois</creatorcontrib><creatorcontrib>Ly, Andre</creatorcontrib><creatorcontrib>Piagnerelli, Michael</creatorcontrib><creatorcontrib>Sauneuf, Bertrand</creatorcontrib><creatorcontrib>Serck, Nicolas</creatorcontrib><creatorcontrib>Soumagne, Thibaud</creatorcontrib><creatorcontrib>Szychowiak, Piotr</creatorcontrib><creatorcontrib>Textoris, Julien</creatorcontrib><creatorcontrib>Vandenbunder, Benoit</creatorcontrib><creatorcontrib>Vinsonneau, Christophe</creatorcontrib><creatorcontrib>Lascarrou, Jean- Baptiste</creatorcontrib><creatorcontrib>COVADIS study group</creatorcontrib><creatorcontrib>for the COVADIS study group</creatorcontrib><collection>SpringerOpen website</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>Annals of intensive care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grimaldi, David</au><au>Aissaoui, Nadia</au><au>Blonz, Gauthier</au><au>Carbutti, Giuseppe</au><au>Courcelle, Romain</au><au>Gaudry, Stephane</au><au>Gaultier, Aurelie</au><au>D’hondt, Alain</au><au>Higny, Julien</au><au>Horlait, Geoffrey</au><au>Hraiech, Sami</au><au>Lefebvre, Laurent</au><au>Lejeune, Francois</au><au>Ly, Andre</au><au>Piagnerelli, Michael</au><au>Sauneuf, Bertrand</au><au>Serck, Nicolas</au><au>Soumagne, Thibaud</au><au>Szychowiak, Piotr</au><au>Textoris, Julien</au><au>Vandenbunder, Benoit</au><au>Vinsonneau, Christophe</au><au>Lascarrou, Jean- Baptiste</au><aucorp>COVADIS study group</aucorp><aucorp>for the COVADIS study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characteristics and outcomes of acute respiratory distress syndrome related to COVID-19 in Belgian and French intensive care units according to antiviral strategies: the COVADIS multicentre observational study</atitle><jtitle>Annals of intensive care</jtitle><stitle>Ann. Intensive Care</stitle><addtitle>Ann Intensive Care</addtitle><date>2020-10-06</date><risdate>2020</risdate><volume>10</volume><issue>1</issue><spage>131</spage><epage>11</epage><pages>131-11</pages><artnum>131</artnum><issn>2110-5820</issn><eissn>2110-5820</eissn><abstract>Background Limited data are available regarding antiviral therapy efficacy in most severe patients under mechanical ventilation for Covid-19-related acute respiratory distress syndrome (ARDS). Methods Comparison of antiviral strategies (none, hydroxychloroquine (OHQ), lopinavir/ritonavir (L/R), others (combination or remdesivir) in an observational multicentre cohort of patients with moderate-to-severe Covid-19 ARDS. The primary endpoint was the number of day 28 ventilator-free days (VFD). Patients who died before d28 were considered as having 0 VFD. The variable was dichotomized into “patients still ventilated or dead at day 28” versus “patients weaned and alive at day 28”. Results We analyzed 415 patients (85 treated with standard of care (SOC), 57 with L/R, 220 with OHQ, and 53 others). The median number of d28-VFD was 0 (IQR 0–13) and differed between groups ( P  = 0.03), SOC patients having the highest d28-VFD. After adjustment for age, sex, Charlson Comorbidity Index, PaO 2 /FiO 2 ratio and plateau pressure and accounting for center effect with a generalized linear mixed model, none of the antiviral strategies increased the chance of being alive and weaned from MV at day 28 compared to the SOC strategy (OR 0.48 CI95% (0.18–1.25); OR 0.96 (0.47–2.02) and OR 1.43 (0.53–4.04) for L/R, OHQ and other treatments, respectively). Acute kidney injury during ICU stay was frequent (55%); its incidence was higher in patients receiving lopinavir (66 vs 53%, P  = 0.03). After adjustment for age, sex, BMI, chronic hypertension and chronic renal disease, the use of L/R was associated with an increased risk of renal replacement therapy (RRT). (OR 2.52 CI95% 1.16–5.59). Conclusion In this multicentre observational study of moderate-to-severe Covid-19 ARDS patients, we did not observe any benefit among patients treated with OHQ or L/R compared with SOC. The use of L/R treatment was associated with an increased need for RRT. Take home message Neither hydroxychloroquine nor lopinavir/ritonavir as COVID-19 antiviral treatment is associated with higher ventilator-free days at day 28 when compared with standard of care (no antiviral treatment) in ICU patients under invasive mechanical ventilation. Lopinavir/ritonavir is associated with an increased risk of renal replacement therapy requirement. Tweet COVID-19: Insights from ARDS cohort: no signal of efficacy of any antiviral drugs. Lopinavir/ritonavir may be associated with need for RRT</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>33025225</pmid><doi>10.1186/s13613-020-00751-y</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-8428-065X</orcidid><orcidid>https://orcid.org/0000-0002-8266-1210</orcidid><orcidid>https://orcid.org/0000-0002-3821-9337</orcidid><orcidid>https://orcid.org/0000-0003-3706-078X</orcidid><orcidid>https://orcid.org/0000-0001-5123-9538</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 2110-5820
ispartof Annals of intensive care, 2020-10, Vol.10 (1), p.131-11, Article 131
issn 2110-5820
2110-5820
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_4f559f56b3bc4e7f91d7e93bc9d0b06d
source PubMed Central(OpenAccess); Springer Nature - SpringerLink Journals - Fully Open Access; ProQuest Publicly Available Content database
subjects Acute kidney injury
Anesthesiology
Critical Care Medicine
Emergency Medicine
Emerging diseases
Human health and pathology
Hydroxychloroquine
Infectious diseases
Intensive
Life Sciences
Lopinavir
Medicine
Medicine & Public Health
Pharmaceutical sciences
Pharmacology
Pulmonology and respiratory tract
Remdesivir
Renal replacement therapy
Ritonavir
Santé publique et épidémiologie
title Characteristics and outcomes of acute respiratory distress syndrome related to COVID-19 in Belgian and French intensive care units according to antiviral strategies: the COVADIS multicentre observational study
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T05%3A08%3A27IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Characteristics%20and%20outcomes%20of%20acute%20respiratory%20distress%20syndrome%20related%20to%20COVID-19%20in%20Belgian%20and%20French%20intensive%20care%20units%20according%20to%20antiviral%20strategies:%20the%20COVADIS%20multicentre%20observational%20study&rft.jtitle=Annals%20of%20intensive%20care&rft.au=Grimaldi,%20David&rft.aucorp=COVADIS%20study%20group&rft.date=2020-10-06&rft.volume=10&rft.issue=1&rft.spage=131&rft.epage=11&rft.pages=131-11&rft.artnum=131&rft.issn=2110-5820&rft.eissn=2110-5820&rft_id=info:doi/10.1186/s13613-020-00751-y&rft_dat=%3Cproquest_doaj_%3E2449181895%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c613t-50850794cceb6ca6ec86c68305375c8f154fdd6ce79e1abb54126394c60f98923%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2449181895&rft_id=info:pmid/33025225&rfr_iscdi=true