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Clinical Frontiers in Critically Ill Patients with COVID-19: Complications, Outcomes...
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Clinical Frontiers in Critically Ill Patients with COVID-19: Complications, Outcomes and Long-Term Care

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Intensive Care".

Deadline for manuscript submissions: closed (20 June 2022) | Viewed by 5274

Special Issue Editors

Dr. Kevin Roedl

E-Mail Website
Guest Editor
Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Interests: critical care; cardiopulmonary resuscitation; cardiac arrest; liver failure; pulmonary critical care
Prof. Dr. Valentin Fuhrmann

E-Mail Website
Guest Editor
1. Hospital Duisburg-Nord, Department of Internal Medicine and Gastroenterology, Duisburg, Germany
2. Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Interests: Critical Care; Liver Failure; Liver Cirrhosis; Acute-on-Chronic Liver Failure; Acute Liver Failure; Hypoxic Liver Injury
Prof. Dr. Dominic Wichmann

E-Mail Website
Guest Editor
Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Interests: Critical Care; COVID-19; Infectious Diseases; Antibiotic and Antimykotic Therapies; Tropical Medicine; Therapeutic Drug Monitoring in ICU patients
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged in 2019 and led to a worldwide healthcare emergency. Around the world, coronavirus disease (COVID-19) has led to a high number of patients in need of hospital admission. About 5% of patients with COVID-19 need intensive care unit (ICU) admission and further organ support. Although primarily impacting the respiratory system, SARS-CoV-2 can involve multiple organs. During the past year, different treatment strategies have been proposed and have showed positive effects on the survival of critically ill patients. However, mortality rates remain unacceptably high in critically ill patients with COVID-19.

The aim of this Special Issue of the Journal of Clinical Medicine is to investigate COVID-19 and its clinical frontiers in critically ill patients. This Special Issue further intends to describe clinical features, complications and outcomes of critically ill patients with COVID-19. Furthermore, research dealing with long-term outcomes of patients or patients with prolonged critical illness is very welcome. Researchers are encouraged to address unanswered questions in the clinical management of critically ill patients with COVID-19.

Dr. Kevin Roedl
Prof. Dr. Valentin Fuhrmann  
Prof. Dr. Dominic Wichmann
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COVID-19
  • Multiple organ failure
  • ARDS
  • Mechanical ventilation
  • Extracorporeal membrane oxygenation
  • Outcomes
  • Prolonged illness
  • Acute kidney injury

Published Papers (3 papers)

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12 pages, 282 KiB  
Article
Exercise Limitation after Critical versus Mild COVID-19 Infection: A Metabolic Perspective
by Maurice Joris, Joël Pincemail, Camille Colson, Jean Joris, Doriane Calmes, Etienne Cavalier, Benoit Misset, Julien Guiot, Grégory Minguet and Anne-Françoise Rousseau
J. Clin. Med. 2022, 11(15), 4322; https://doi.org/10.3390/jcm11154322 - 25 Jul 2022
Cited by 5 | Viewed by 2022
Abstract
Exercise limitation in COVID-19 survivors is poorly explained. In this retrospective study, cardiopulmonary exercise testing (CPET) was coupled with an oxidative stress assessment in COVID-19 critically ill survivors (ICU group). Thirty-one patients were included in this group. At rest, their oxygen uptake (VO [...] Read more.
Exercise limitation in COVID-19 survivors is poorly explained. In this retrospective study, cardiopulmonary exercise testing (CPET) was coupled with an oxidative stress assessment in COVID-19 critically ill survivors (ICU group). Thirty-one patients were included in this group. At rest, their oxygen uptake (VO2) was elevated (8 [5.6–9.7] mL/min/kg). The maximum effort was reached at low values of workload and VO2 (66 [40.9–79.2]% and 74.5 [62.6–102.8]% of the respective predicted values). The ventilatory equivalent for carbon dioxide remained within normal ranges. Their metabolic efficiency was low: 15.2 [12.9–17.8]%. The 50% decrease in VO2 after maximum effort was delayed, at 130 [120–170] s, with a still-high respiratory exchange ratio (1.13 [1–1.2]). The blood myeloperoxidase was elevated (92 [75.5–106.5] ng/mL), and the OSS was altered. The CPET profile of the ICU group was compared with long COVID patients after mid-disease (MLC group) and obese patients (OB group). The MLC patients (n = 23) reached peak workload and predicted VO2 values, but their resting VO2, metabolic efficiency, and recovery profiles were similar to the ICU group to a lesser extent. In the OB group (n = 15), no hypermetabolism at rest was observed. In conclusion, the exercise limitation after a critical COVID-19 bout resulted from an altered metabolic profile in the context of persistent inflammation and oxidative stress. Altered exercise and metabolic profiles were also observed in the MLC group. The contribution of obesity on the physiopathology of exercise limitation after a critical bout of COVID-19 did not seem relevant. Full article
(This article belongs to the Special Issue Clinical Frontiers in Critically Ill Patients with COVID-19: Complications, Outcomes and Long-Term Care)
11 pages, 838 KiB  
Article
Chronic Critical Illness in Patients with COVID-19: Characteristics and Outcome of Prolonged Intensive Care Therapy
by Kevin Roedl, Dominik Jarczak, Olaf Boenisch, Geraldine de Heer, Christoph Burdelski, Daniel Frings, Barbara Sensen, Axel Nierhaus, Stefan Kluge and Dominic Wichmann
J. Clin. Med. 2022, 11(4), 1049; https://doi.org/10.3390/jcm11041049 - 17 Feb 2022
Cited by 12 | Viewed by 1706
Abstract
The spread of SARS-CoV-2 caused a worldwide healthcare threat. High critical care admission rates related to Coronavirus Disease 2019 (COVID-19) respiratory failure were observed. Medical advances helped increase the number of patients surviving the acute critical illness. However, some patients require prolonged critical [...] Read more.
The spread of SARS-CoV-2 caused a worldwide healthcare threat. High critical care admission rates related to Coronavirus Disease 2019 (COVID-19) respiratory failure were observed. Medical advances helped increase the number of patients surviving the acute critical illness. However, some patients require prolonged critical care. Data on the outcome of patients with a chronic critical illness (CCI) are scarce. Single-center retrospective study including all adult critically ill patients with confirmed COVID-19 treated at the Department of Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf, Germany, between 1 March 2020 and 8 August 2021. We identified 304 critically ill patients with COVID-19 during the study period. Of those, 55% (n = 167) had an ICU stay ≥21 days and were defined as chronic critical illness, and 45% (n = 137) had an ICU stay <21 days. Age, sex and BMI were distributed equally between both groups. Patients with CCI had a higher median SAPS II (CCI: 39.5 vs. no-CCI: 38 points, p = 0.140) and SOFA score (10 vs. 6, p < 0.001) on admission. Seventy-three per cent (n = 223) of patients required invasive mechanical ventilation (MV) (86% vs. 58%; p < 0.001). The median duration of MV was 30 (17–49) days and 7 (4–12) days in patients with and without CCI, respectively (p < 0.001). The regression analysis identified ARDS (OR 3.238, 95% CI 1.827–5.740, p < 0.001) and referral from another ICU (OR 2.097, 95% CI 1.203–3.654, p = 0.009) as factors significantly associated with new-onset of CCI. Overall, we observed an ICU mortality of 38% (n = 115) in the study cohort. In patients with CCI we observed an ICU mortality of 28% (n = 46) compared to 50% (n = 69) in patients without CCI (p < 0.001). The 90-day mortality was 28% (n = 46) compared to 50% (n = 70), respectively (p < 0.001). More than half of critically ill patients with COVID-19 suffer from CCI. Short and long-term survival rates in patients with CCI were high compared to patients without CCI, and prolonged therapy should not be withheld when resources permit prolonged therapy. Full article
(This article belongs to the Special Issue Clinical Frontiers in Critically Ill Patients with COVID-19: Complications, Outcomes and Long-Term Care)
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16 pages, 2260 KiB  
Systematic Review
Systematic Review and Meta-Analysis of Statin Use and Mortality, Intensive Care Unit Admission and Requirement for Mechanical Ventilation in COVID-19 Patients
by Ut-Sam Lao, Chak-Fun Law, Daniel T. Baptista-Hon and Brian Tomlinson
J. Clin. Med. 2022, 11(18), 5454; https://doi.org/10.3390/jcm11185454 - 16 Sep 2022
Cited by 10 | Viewed by 2124
Abstract
There is mounting evidence that statin use is beneficial for COVID-19 outcomes. We performed a systematic review and meta-analysis to evaluate the association between statin use and mortality, intensive care unit (ICU) admission and mechanical ventilation in COVID-19 patients, on studies which provided [...] Read more.
There is mounting evidence that statin use is beneficial for COVID-19 outcomes. We performed a systematic review and meta-analysis to evaluate the association between statin use and mortality, intensive care unit (ICU) admission and mechanical ventilation in COVID-19 patients, on studies which provided covariate adjusted effect estimates, or performed propensity score matching. We searched PubMed, Embase, Web of Science and Scopus for studies and extracted odds or hazard ratios for specified outcome measures. Data synthesis was performed using a random-effects inverse variance method. Risk of bias, heterogeneity and publication bias were analyzed using standard methods. Our results show that statin use was associated with significant reductions in mortality (OR = 0.72, 95% CI: 0.67–0.77; HR = 0.74, 95% CI: 0.69, 0.79), ICU admission (OR = 0.94, 95% CI: 0.89–0.99; HR = 0.76, 95% CI: 0.60–0.96) and mechanical ventilation (OR = 0.84, 95% CI: 0.78–0.92; HR = 0.67, 95% CI: 0.47–0.97). Nevertheless, current retrospective studies are based on the antecedent use of statins prior to infection and/or continued use of statin after hospital admission. The results may not apply to the de novo commencement of statin treatment after developing COVID-19 infection. Prospective studies are lacking and necessary. Full article
(This article belongs to the Special Issue Clinical Frontiers in Critically Ill Patients with COVID-19: Complications, Outcomes and Long-Term Care)
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