Association between mortality and age among mechanically ventilated COVID-19 patients: a Japanese nationwide COVID-19 database study

Abstract Background Only a few studies have reported the association between age and mortality in COVID-19 patients who require invasive mechanical ventilation (IMV). We aimed to evaluate the effect of age on COVID-19-related mortality among patients undergoing IMV therapy. Methods This cohort study was conducted using the COVID-19 Registry Japan database, a nationwide multi-centre study of hospitalized patients with laboratory-confirmed COVID-19. Of all 33,808 cases registered between 1 January 2020 to 28 February 2021, we analysed 1555 patients who had undergone IMV. We evaluated mortality rates between age groups using multivariable regression analysis after adjusting for known potential components, such as within-hospital clustering, comorbidities, steroid use, medication for COVID-19, and vital signs on admission, using generalized estimation equation. Results By age group, the mortality rates in the IMV group were 8.6%, 20.7%, 34.9%, 49.7% and 83.3% for patients in their 50s, 60s, 70s, 80s, and 90s, respectively. Multivariable analysis showed that compared with those for patients aged < 60 years, the odds ratios (95% confidence interval) of death were 2.6 (1.6–4.1), 6.9 (4.2–11.3), 13.2 (7.2–24.1), 92.6 (16.7–515.0) for patients in their 60s, 70s, 80s, and 90s, respectively. Conclusions In this cohort study, age had a great effect on mortality in COVID-19 patients undergoing IMV, after adjusting for variables independently associated with mortality. This study suggested that age was associated with higher mortality and that preventing progression to severe COVID-19 in elderly patients may be a great public health issue.

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Obesity and smoking as risk factors for invasive mechanical ventilation in COVID-19: A retrospective, observational cohort study

PLoS ONE ◽

10.1371/journal.pone.0238552 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0238552

Author(s):

Ana C. Monteiro ◽

Rajat Suri ◽

Iheanacho O. Emeruwa ◽

Robert J. Stretch ◽

Roxana Y. Cortes-Lopez ◽

...

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Smoking Status ◽

Univariate Analysis ◽

Invasive Mechanical Ventilation ◽

Multivariable Analysis ◽

Observational Cohort Study ◽

Smoking History ◽

Observational Cohort ◽

Retrospective Observational Cohort Study

Purpose To describe the trajectory of respiratory failure in COVID-19 and explore factors associated with risk of invasive mechanical ventilation (IMV). Materials and methods A retrospective, observational cohort study of 112 inpatient adults diagnosed with COVID-19 between March 12 and April 16, 2020. Data were manually extracted from electronic medical records. Multivariable and Univariable regression were used to evaluate association between baseline characteristics, initial serum markers and the outcome of IMV. Results Our cohort had median age of 61 (IQR 45–74) and was 66% male. In-hospital mortality was 6% (7/112). ICU mortality was 12.8% (6/47), and 18% (5/28) for those requiring IMV. Obesity (OR 5.82, CI 1.74–19.48), former (OR 8.06, CI 1.51–43.06) and current smoking status (OR 10.33, CI 1.43–74.67) were associated with IMV after adjusting for age, sex, and high prevalence comorbidities by multivariable analysis. Initial absolute lymphocyte count (OR 0.33, CI 0.11–0.96), procalcitonin (OR 1.27, CI 1.02–1.57), IL-6 (OR 1.17, CI 1.03–1.33), ferritin (OR 1.05, CI 1.005–1.11), LDH (OR 1.57, 95% CI 1.13–2.17) and CRP (OR 1.13, CI 1.06–1.21), were associated with IMV by univariate analysis. Conclusions Obesity, smoking history, and elevated inflammatory markers were associated with increased need for IMV in patients with COVID-19.

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Clinical Course and Outcomes of Severe Covid-19: A National Scale Study

Journal of Clinical Medicine ◽

10.3390/jcm9072282 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2282 ◽

Cited By ~ 2

Author(s):

Moran Amit ◽

Alex Sorkin ◽

Jacob Chen ◽

Barak Cohen ◽

Dana Karol ◽

...

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Secondary Infection ◽

Invasive Mechanical Ventilation ◽

Multivariable Analysis ◽

Case Series ◽

Government Officials ◽

Multivariable Regression Model ◽

Multivariable Regression ◽

Overall Mortality

Knowledge of the outcomes of critically ill patients is crucial for health and government officials who are planning how to address local outbreaks. The factors associated with outcomes of critically ill patients with coronavirus disease 2019 (Covid-19) who required treatment in an intensive care unit (ICU) are yet to be determined. Methods: This was a retrospective registry-based case series of patients with laboratory-confirmed SARS-CoV-2 who were referred for ICU admission and treated in the ICUs of the 13 participating centers in Israel between 5 March and 27 April 2020. Demographic and clinical data including clinical management were collected and subjected to a multivariable analysis; primary outcome was mortality. Results: This study included 156 patients (median age = 72 years (range = 22–97 years)); 69% (108 of 156) were male. Eighty-nine percent (139 of 156) of patients had at least one comorbidity. One hundred three patients (66%) required invasive mechanical ventilation. As of 8 May 2020, the median length of stay in the ICU was 10 days (range = 0–37 days). The overall mortality rate was 56%; a multivariable regression model revealed that increasing age (OR = 1.08 for each year of age, 95%CI = 1.03–1.13), the presence of sepsis (OR = 1.08 for each year of age, 95%CI = 1.03–1.13), and a shorter ICU stay(OR = 0.90 for each day, 95% CI = 0.84–0.96) were independent prognostic factors. Conclusions: In our case series, we found lower mortality rates than those in exhausted health systems. The results of our multivariable model suggest that further evaluation is needed of antiviral and antibacterial agents in the treatment of sepsis and secondary infection.

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Data Talks: Obesity-Related Influences on US Mortality Rates

Research in Health Science ◽

10.22158/rhs.v3n3p65 ◽

2018 ◽

Vol 3 (3) ◽

pp. 65 ◽

Cited By ~ 3

Author(s):

Malcolm J. D’Souza ◽

Riza C. Bautista ◽

Derald E. Wentzien

Keyword(s):

Death Certificate ◽

Age Groups ◽

Mortality Rates ◽

Overweight And Obesity ◽

Public Health Issue ◽

Minority Population ◽

Death Rates ◽

Age Related ◽

The Us ◽

Icd 10

Background: In the US, obesity is an epidemiologic challenge and the population fails to comprehend this complex public health issue. To evaluate underlying obesity-impact patterns on mortality rates, we data-mined the 1999-2016 Center for Disease Control WONDER database’s vital records.Methods: Adopting SAS programming, we scrutinized the mortality and population counts. Using ICD-10 diagnosis codes connected to overweight and obesity, we obtained the obesity-related crude and age-adjusted causes of death. To understand divergent and prevalence trends we compared and contrasted the tabulated obesity-influenced mortality rates with demographic information, gender, and age-related data.Key Results: From 1999 to 2016, the obesity-related age-adjusted mortality rates increased by 142%. The ICD-10 overweight and obesity-related death-certificate coding showed clear evidence that obesity factored in the male age-adjusted mortality rate increment to 173% and the corresponding female rate to 117%. It also disproportionately affected the nation-wide minority population death rates. Furthermore, excess weight distributions are coded as contributing features in the crude death rates for all decennial age-groups.Conclusions: The 1999-2016 data from ICD-10 death certificate coding for obesity-related conditions indicate that it is affecting all segments of the US population.

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Awake prone positioning does not reduce the risk of intubation in COVID-19 treated with High-Flow Nasal Oxygen therapy. A multicenter, adjusted cohort study

10.21203/rs.3.rs-53558/v2 ◽

2020 ◽

Author(s):

Carlos Ferrando ◽

Ricard Mellado-Artigas ◽

Alfredo Gea ◽

Egoitz Arruti ◽

César Aldecoa ◽

...

Keyword(s):

Cohort Study ◽

Oxygen Therapy ◽

Invasive Mechanical Ventilation ◽

Vital Signs ◽

Logistic Models ◽

High Flow ◽

Prone Positioning ◽

Reactive Protein ◽

Icu Length Of Stay ◽

Score Apache

Abstract Background Awake prone positioning (awake-PP) in non-intubated coronavirus disease 2019 (COVID-19) patients could avoid endotracheal intubation, reduce the use of critical care resources, and improve survival. We aimed to examine whether the combination of high-flow nasal oxygen therapy (HFNO) with awake-PP prevents the need for intubation when compared to HFNO alone. Methods Prospective, multicentre, adjusted observational cohort study in consecutive COVID-19 patients with acute respiratory failure (ARF) receiving respiratory support with HFNO from 12 March to 9 June, 2020. Patients were classified as HFNO with or without awake-PP. Logistic models were fitted to predict treatment at baseline using the following variables: age, sex, obesity, non-respiratory sequential organ failure assessment score, APACHE-II, C-reactive protein, days from symptoms onset to HFNO initiation, respiratory rate and peripheral oxyhemoglobin saturation. We compared data on demographics, vital signs, laboratory markers, need for invasive mechanical ventilation, days to intubation, ICU length of stay, and ICU mortality between HFNO patients with and without awake-PP. Results A total of 1076 patients with COVID-19 ARF were admitted, of which 199 patients received HFNO and were analyzed. Fifty-five (27.6%) were pronated during HFNO; 60 (41%) and 22 (40%) patients from the HFNO and HFNO+awake-PP groups were intubated. The use of awake-PP as an adjunctive therapy to HFNO did not reduce the risk of intubation [RR 0.87 (95%CI: 0.53–1.43), p=0.60]. Patients treated with HFNO+awake-PP showed a trend for delay in intubation compared to HFNO alone [median 1 (interquartile range, IQR 1.0-2.5) vs 2 IQR 1.0-3.0] days, (p=0.055), but awake-PP did not affect 28-day mortality [RR 1.04 (95%CI: 0.40–2.72), p=0.92]. Conclusion In patients with COVID-19 ARF treated with HFNO, the use of awake-PP did not reduce the need for intubation or affect mortality.

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Own migration experience is not a risk factor for incident cardiovascular disease – a cohort study

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.733 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L Krist ◽

C Dornquast ◽

T Reinhold ◽

S Solak ◽

M Durak ◽

...

Keyword(s):

Cohort Study ◽

First Generation ◽

Multivariable Analysis ◽

Health Behaviours ◽

Public Health Research ◽

Self Report ◽

Migration Experience ◽

Multivariable Regression ◽

Ischaemic Attack ◽

First Generation Migrants

Abstract Background Studies have shown differences regarding prevalence and incidence of chronic diseases among first (own migration experience) compared to second (born in host country) generation migrants. The aim of this study was therefore to investigate the incidence of cardiovascular diseases (CVD) among persons of Turkish descent with and without migration experience living in Berlin, Germany. Methods In 2012-2013, Berliners with a Turkish migration background were recruited, examined, and contacted again 5 years later via postal mail. Incidence of diagnosed CVD (myocardial infarction, stroke, coronary heart disease, heart failure, cardiac arrhythmia, intermittent claudicatio or transient ischaemic attack) was assessed via self-report. Incidence of any CVD is presented as number and percentages. Associations between the incidence of any CVD and having an own migration experience were investigated with uni- and multivariable regression analyses. Results are presented as odds ratios with a 95%-confidence interval (OR, 95%-CI). Results Data of 234 persons of Turkish descent (62.8% women) with a mean age±standard deviation of 44±12.4 years were included in the analyses. Out of these, 79.9% were first generation migrants. First compared to second generation participants differed regarding CVD incidence (any CVD 16.6% vs. 4.3%, respectively; p = 0.03), socio-demographic, and lifestyle factors. After adjusting for these factors, multivariable analysis showed that only BMI (OR 1.12 per BMI point, 95%CI [1.02;1.24], and having a diagnosis of dyslipidemia (OR 4.0, 95%CI [1.45;12.05]), were independently associated with CVD incidence. Conclusions In a cohort study with Berliners of Turkish descent, CVD incidence was associated with increasing BMI and dyslipidemia, but not with own migration experience. Future migration-related public health research needs to focus on the prevention of harmful health behaviours to avoid the progression of overweight/obesity and dyslipidemia. Key messages CVD incidence is higher in persons with migration experience compared to those without. Migration experience is not associated with CVD incidence after adjusting for confounders (e.g. age, BMI).

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Clinical profile and factors associated with COVID-19 in Cameroon: a prospective cohort study

10.1101/2021.02.19.21252071 ◽

2021 ◽

Author(s):

Nicole Fouda Mbarga ◽

Epee Emilienne ◽

Marcel Mbarga ◽

Patrick Ouamba ◽

Herwin Nanda ◽

...

Keyword(s):

Cohort Study ◽

Respiratory Distress ◽

Disease Severity ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Multivariable Analysis ◽

Age Groups ◽

Clinical Signs ◽

Case Fatality ◽

Factors Associated

AbstractObjectivesThis study explores the clinical profiles and factors associated with COVID-19 in Cameroon.Research design and methodsIn this prospective cohort study, we followed patients admitted for suspicion of COVID-19 at Djoungolo Hospital between 01st April and 31st July 2020. Patients were categorised by age groups and disease severity: mild (symptomatic without clinical signs of pneumonia pneumonia), moderate (with clinical signs of pneumonia without respiratory distress) and severe cases (clinical signs of pneumonia and respiratory distress not requiring invasive ventilation). Demographic information and clinical features were summarised. Multivariable analysis was performed to predict risk.ResultsA total of 323 patients were admitted during the study period; 262 were confirmed cases of COVID-19 by Polymerase Chain Reaction (PCR). Among the confirmed cases, the male group aged 40 to 49 years (13.9%) was predominant. Disease severity ranged from mild (77%; N=204) to moderate (15%; N=40) to severe (7%; N=18); the case fatality rate was 1% (N=4). Dysgusia (46%; N=111) and hyposmia/anosmia (39%; N=89) were common features of COVID-19. Nearly one-third of patients had comorbidities (29%; N=53), of which hypertension was the most common (20%; N=48). Participation in a mass gathering (OR=5.47; P=0.03) was a risk factor for COVID-19. Age groups 60 to 69 (OR=7.41; P=0.0001), 50 to 59 (OR=4.09; P=0.03), 40 to 49 (OR=4.54; P=0.01), male gender (OR=2.53; P=0.04), diabetes (OR= 4.05; P= 0.01), HIV infection (OR=5.57; P=0.03), lung disease (OR= 6.29; P=0.01), dyspnoea (OR=3.70; P=0.008) and fatigue (OR=3.35; P=0.02) significantly predicted COVID-19 severity.ConclusionUnlike many high-income settings, most COVID-19 cases in this study were benign with low fatality. Such findings may guide public health decision-making.

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Increased susceptibility to intensive care unit-acquired pneumonia in severe COVID-19 patients: a multicentre retrospective cohort study

Annals of Intensive Care ◽

10.1186/s13613-021-00812-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jean-François Llitjos ◽

Swann Bredin ◽

Jean-Baptiste Lascarrou ◽

Thibaud Soumagne ◽

Mariana Cojocaru ◽

...

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Invasive Mechanical Ventilation ◽

Viral Pneumonia ◽

Control Groups ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Multicentre Cohort Study ◽

Multicentre Cohort ◽

Ventilated Patients

Abstract Background The aim of this study is to determine whether severe COVID-19 patients harbour a higher risk of ICU-acquired pneumonia. Methods This retrospective multicentre cohort study comprised all consecutive patients admitted to seven ICUs for severe COVID-19 pneumonia during the first COVID-19 surge in France. Inclusion criteria were laboratory-confirmed SARS-CoV-2 infection and requirement for invasive mechanical ventilation for 48 h or more. Control groups were two historical cohorts of mechanically ventilated patients admitted to the ICU for bacterial or non-SARS-CoV-2 viral pneumonia. The outcome of interest was the development of ICU-acquired pneumonia. The determinants of ICU-acquired pneumonia were investigated in a multivariate competing risk analysis. Result One hundred and seventy-six patients with severe SARS-CoV-2 pneumonia admitted to the ICU between March 1st and 30th June of 2020 were included into the study. Historical control groups comprised 435 patients with bacterial pneumonia and 48 ones with viral pneumonia. ICU-acquired pneumonia occurred in 52% of COVID-19 patients, whereas in 26% and 23% of patients with bacterial or viral pneumonia, respectively (p < 0.001). Times from initiation of mechanical ventilation to ICU-acquired pneumonia were similar across the three groups. In multivariate analysis, the risk of ICU-acquired pneumonia remained independently associated with underlying COVID-19 (SHR = 2.18; 95 CI 1.2–3.98, p = 0.011). Conclusion COVID-19 appears an independent risk factor of ICU-acquired pneumonia in mechanically ventilated patients with pneumonia. Whether this is driven by immunomodulatory properties by the SARS-CoV-2 or this is related to particular processes of care remains to be investigated.

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Effect of Tocilizumab in Hospitalized Patients with Severe COVID-19 Pneumonia: A Case-Control Cohort Study

Pharmaceuticals ◽

10.3390/ph13100317 ◽

2020 ◽

Vol 13 (10) ◽

pp. 317 ◽

Cited By ~ 3

Author(s):

Benjamin Rossi ◽

Lee S. Nguyen ◽

Philippe Zimmermann ◽

Faiza Boucenna ◽

Louis Dubret ◽

...

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Single Dose ◽

Primary Outcome ◽

Invasive Mechanical Ventilation ◽

Multivariable Analysis ◽

Control Group ◽

Care Hospital ◽

Primary Care Hospital

Tocilizumab, an anti-interleukin-6 receptor, administrated during the right timeframe may be beneficial against coronavirus-disease-2019 (COVID-19) pneumonia. All patients admitted for severe COVID-19 pneumonia (SpO2 ≤ 96% despite O2-support ≥ 6 L/min) without invasive mechanical ventilation were included in a retrospective cohort study in a primary care hospital. The treatment effect of a single-dose, 400 mg, of tocilizumab was assessed by comparing those who received tocilizumab to those who did not. Selection bias was mitigated using three statistical methods. Primary outcome measure was a composite of mortality and ventilation at day 28. A total of 246 patients were included (106 were treated with tocilizumab). Overall, 105 (42.7%) patients presented the primary outcome, with 71 (28.9%) deaths during the 28-day follow-up. Propensity-score-matched 84 pairs of comparable patients. In the matched cohort (n = 168), tocilizumab was associated with fewer primary outcomes than the control group (hazard ratio (HR) = 0.49 (95% confidence interval (95%CI) = 0.3–0.81), p-value = 0.005). These results were similar in the overall cohort (n = 246), with Cox multivariable analysis yielding a protective association between tocilizumab and primary outcome (adjusted HR = 0.26 (95%CI = 0.135–0.51, p = 0.0001), confirmed by inverse probability score weighting (IPSW) analysis (p < 0.0001). Analyses on mortality only, with 28 days of follow-up, yielded similar results. In this study, tocilizumab 400 mg in a single-dose was associated with improved survival without mechanical ventilation in patients with severe COVID-19.

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Awake prone positioning does not reduce the risk of intubation in COVID-19 treated with high-flow nasal oxygen therapy: a multicenter, adjusted cohort study

Critical Care ◽

10.1186/s13054-020-03314-6 ◽

2020 ◽

Vol 24 (1) ◽

Author(s):

Carlos Ferrando ◽

◽

Ricard Mellado-Artigas ◽

Alfredo Gea ◽

Egoitz Arruti ◽

...

Keyword(s):

Cohort Study ◽

Oxygen Therapy ◽

Invasive Mechanical Ventilation ◽

Vital Signs ◽

Logistic Models ◽

High Flow ◽

Prone Positioning ◽

Reactive Protein ◽

Icu Length Of Stay ◽

Score Apache

Abstract Background Awake prone positioning (awake-PP) in non-intubated coronavirus disease 2019 (COVID-19) patients could avoid endotracheal intubation, reduce the use of critical care resources, and improve survival. We aimed to examine whether the combination of high-flow nasal oxygen therapy (HFNO) with awake-PP prevents the need for intubation when compared to HFNO alone. Methods Prospective, multicenter, adjusted observational cohort study in consecutive COVID-19 patients with acute respiratory failure (ARF) receiving respiratory support with HFNO from 12 March to 9 June 2020. Patients were classified as HFNO with or without awake-PP. Logistic models were fitted to predict treatment at baseline using the following variables: age, sex, obesity, non-respiratory Sequential Organ Failure Assessment score, APACHE-II, C-reactive protein, days from symptoms onset to HFNO initiation, respiratory rate, and peripheral oxyhemoglobin saturation. We compared data on demographics, vital signs, laboratory markers, need for invasive mechanical ventilation, days to intubation, ICU length of stay, and ICU mortality between HFNO patients with and without awake-PP. Results A total of 1076 patients with COVID-19 ARF were admitted, of which 199 patients received HFNO and were analyzed. Fifty-five (27.6%) were pronated during HFNO; 60 (41%) and 22 (40%) patients from the HFNO and HFNO + awake-PP groups were intubated. The use of awake-PP as an adjunctive therapy to HFNO did not reduce the risk of intubation [RR 0.87 (95% CI 0.53–1.43), p = 0.60]. Patients treated with HFNO + awake-PP showed a trend for delay in intubation compared to HFNO alone [median 1 (interquartile range, IQR 1.0–2.5) vs 2 IQR 1.0–3.0] days (p = 0.055), but awake-PP did not affect 28-day mortality [RR 1.04 (95% CI 0.40–2.72), p = 0.92]. Conclusion In patients with COVID-19 ARF treated with HFNO, the use of awake-PP did not reduce the need for intubation or affect mortality.

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Long-term survival of mechanically ventilated patients with severe COVID-19: an observational cohort study

Annals of Intensive Care ◽

10.1186/s13613-021-00929-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Oscar Peñuelas ◽

Laura del Campo-Albendea ◽

Amanda Lesmes González de Aledo ◽

José Manuel Añón ◽

Carmen Rodríguez-Solís ◽

...

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Predictive Factors ◽

Invasive Mechanical Ventilation ◽

Term Survival ◽

Long Term Survival ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Ventilated Patients

Abstract Background Information is lacking regarding long-term survival and predictive factors for mortality in patients with acute hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19) and undergoing invasive mechanical ventilation. We aimed to estimate 180-day mortality of patients with COVID-19 requiring invasive ventilation, and to develop a predictive model for long-term mortality. Methods Retrospective, multicentre, national cohort study between March 8 and April 30, 2020 in 16 intensive care units (ICU) in Spain. Participants were consecutive adults who received invasive mechanical ventilation for COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection detected in positive testing of a nasopharyngeal sample and confirmed by real time reverse-transcriptase polymerase chain reaction (rt-PCR). The primary outcomes was 180-day survival after hospital admission. Secondary outcomes were length of ICU and hospital stay, and ICU and in-hospital mortality. A predictive model was developed to estimate the probability of 180-day mortality. Results 868 patients were included (median age, 64 years [interquartile range [IQR], 56–71 years]; 72% male). Severity at ICU admission, estimated by SAPS3, was 56 points [IQR 50–63]. Prior to intubation, 26% received some type of noninvasive respiratory support. The unadjusted overall 180-day survival rates was 59% (95% CI 56–62%). The predictive factors measured during ICU stay, and associated with 180-day mortality were: age [Odds Ratio [OR] per 1-year increase 1.051, 95% CI 1.033–1.068)), SAPS3 (OR per 1-point increase 1.027, 95% CI 1.011–1.044), diabetes (OR 1.546, 95% CI 1.085–2.204), neutrophils to lymphocytes ratio (OR per 1-unit increase 1.008, 95% CI 1.001–1.016), failed attempt of noninvasive positive pressure ventilation prior to orotracheal intubation (OR 1.878 (95% CI 1.124–3.140), use of selective digestive decontamination strategy during ICU stay (OR 0.590 (95% CI 0.358–0.972) and administration of low dosage of corticosteroids (methylprednisolone 1 mg/kg) (OR 2.042 (95% CI 1.205–3.460). Conclusion The long-term survival of mechanically ventilated patients with severe COVID-19 reaches more than 50% and may help to provide individualized risk stratification and potential treatments. Trial registration: ClinicalTrials.gov Identifier: NCT04379258. Registered 10 April 2020 (retrospectively registered)

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