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• W3125220011 abstract "It was with great interest that we read the recent systematic review by Serafim and colleagues [[1]Serafim R.B. Póvoa P. Souza-Dantas V. Kalil A.C. Salluh J.I.F. Clinical course and outcomes of critically ill patients with COVID-19 infection: a systematic review.Clin Microbiol Infect. 2021; 27: 47-54Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar], in which they describe overall outcomes for patients with severe coronavirus disease 2019 (COVID-19) pneumonia, across many countries, who required admission to an intensive care unit (ICU). Importantly, they also describe various therapies used in treating COVID-19 patients in the ICU, and some of the associated outcomes. Their important work adds to the growing knowledge of COVID-19 and we congratulate them on this publication. In Figure 2 of their article more than 30 countries that were included in the systematic review are depicted [[1]Serafim R.B. Póvoa P. Souza-Dantas V. Kalil A.C. Salluh J.I.F. Clinical course and outcomes of critically ill patients with COVID-19 infection: a systematic review.Clin Microbiol Infect. 2021; 27: 47-54Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar]. Included in this figure is Canada, with 200–700 patients apparently represented; however, there does not appear to be an associated reference for the Canadian data. We performed a MEDLINE search from inception to 3 January 2021 using the following keywords: ‘COVID-19’, ‘Intensive Care’ and ‘Canada’, and found three observational studies describing COVID-19 ICU outcomes in Canada [2Mitra A.R. Fergusson N.A. Lloyd-Smith E. Wormsbecker A. Foster D. Karpov A. et al.Baseline characteristics and outcomes of patients with COVID-19 admitted to intensive care units in Vancouver, Canada: a case series.CMAJ. 2020; 192: E694-E701Crossref PubMed Scopus (70) Google Scholar, 3Cavayas Y.A. Noël A. Brunette V. Williamson D. Frenette A.J. Arsenault C. et al.Early experience with critically ill patients with COVID-19 in Montreal.Can J Anaesth. 2021; 68: 204-213Crossref PubMed Scopus (14) Google Scholar, 4Yang S.S. Lipes J. Dial S. Schwartz B. Laporta D. Wong E. et al.Outcomes and clinical practice in patients with COVID-19 admitted to the intensive care unit in Montréal, Canada: a descriptive analysis.CMAJ Open. 2020; 8: E788-E795Crossref PubMed Scopus (15) Google Scholar]. The studies were published between May and November 2020, describe patients in Canada during the first wave of the Canadian COVID-19 pandemic, and satisfy all of the authors inclusion criteria. Only the study by Mitra et al. (117 patients) was available at the time of the search by Serafim et al., and ideally should have been included in the primary analysis [[2]Mitra A.R. Fergusson N.A. Lloyd-Smith E. Wormsbecker A. Foster D. Karpov A. et al.Baseline characteristics and outcomes of patients with COVID-19 admitted to intensive care units in Vancouver, Canada: a case series.CMAJ. 2020; 192: E694-E701Crossref PubMed Scopus (70) Google Scholar]. In the three Canadian studies, a total of 298 ICU patients were described. The ICU mortality in this Canadian cohort ranged from 15% to 23% with similar ICU lengths of stay, use of invasive mechanical ventilation and renal replacement therapy (Table 1). Mortality in patients undergoing invasive mechanical ventilation was approximately 20% in all three studies, which is considerably lower than reported in other jurisdictions [[1]Serafim R.B. Póvoa P. Souza-Dantas V. Kalil A.C. Salluh J.I.F. Clinical course and outcomes of critically ill patients with COVID-19 infection: a systematic review.Clin Microbiol Infect. 2021; 27: 47-54Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar].Table 1Characteristics and outcomes for COVID-19 patients admitted to intensive care units in CanadaAuthorMitra et al. [[2]Mitra A.R. Fergusson N.A. Lloyd-Smith E. Wormsbecker A. Foster D. Karpov A. et al.Baseline characteristics and outcomes of patients with COVID-19 admitted to intensive care units in Vancouver, Canada: a case series.CMAJ. 2020; 192: E694-E701Crossref PubMed Scopus (70) Google Scholar]Cavayas et al. [[3]Cavayas Y.A. Noël A. Brunette V. Williamson D. Frenette A.J. Arsenault C. et al.Early experience with critically ill patients with COVID-19 in Montreal.Can J Anaesth. 2021; 68: 204-213Crossref PubMed Scopus (14) Google Scholar]Yang et al. [[4]Yang S.S. Lipes J. Dial S. Schwartz B. Laporta D. Wong E. et al.Outcomes and clinical practice in patients with COVID-19 admitted to the intensive care unit in Montréal, Canada: a descriptive analysis.CMAJ Open. 2020; 8: E788-E795Crossref PubMed Scopus (15) Google Scholar]Age (years)696266Male79 (68%)50 (67%)64 (60%)Sample size11775106NIV15 (13%)16 (21%)0 (0%)HFNO43 (37%)2 (3%)51 (48%)IMV74 (63%)43 (57%)65 (61%)ECMO3 (3%)1 (1%)0 (0%)RRT16 (14%)7 (9%)12 (11%)Vasopressors65 (56%)NANAICU LOS (days)91010ICU mortality18 (15%)17 (23%)18 (17%)ICU mortality if IMV used15 (20%)8 (19%)12 (19%)Hospital mortality30 (26%)19 (25%)21 (20%)Abbreviations: COVID-19, coronavirus disease 2019; ECMO, extracorporeal membrane oxygenation; HFNO, high-flow nasal oxygen; IMV, invasive mechanical ventilation; LOS, length of stay; NIV, non-invasive ventilation; RRT, renal replacement therapy. Open table in a new tab Abbreviations: COVID-19, coronavirus disease 2019; ECMO, extracorporeal membrane oxygenation; HFNO, high-flow nasal oxygen; IMV, invasive mechanical ventilation; LOS, length of stay; NIV, non-invasive ventilation; RRT, renal replacement therapy. The observed ICU mortality across several hospital settings in Canada describes a lower mortality compared with the observed outcomes internationally described by Serafim et al. [[1]Serafim R.B. Póvoa P. Souza-Dantas V. Kalil A.C. Salluh J.I.F. Clinical course and outcomes of critically ill patients with COVID-19 infection: a systematic review.Clin Microbiol Infect. 2021; 27: 47-54Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar]. We hope this information complements the message of the authors and completes the missing data. More research will be required to better understand why different outcomes have been observed across international borders. Clinical course and outcomes of critically ill patients with COVID-19 infection: a systematic reviewClinical Microbiology and InfectionVol. 27Issue 1PreviewCoronavirus disease 19 (COVID-19) is a major cause of hospital admission and represents a challenge for patient management during intensive care unit (ICU) stay. We aimed to describe the clinical course and outcomes of COVID-19 pneumonia in critically ill patients. Full-Text PDF Open ArchiveRe: ‘Clinical course and outcomes of critically ill patients with COVID-19 infection: a systematic review - authors' reply’Clinical Microbiology and InfectionVol. 27Issue 6PreviewWe thank Dr Lipes for his comments about our systematic review [1]. Full-Text PDF Open Archive" @default.
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• W3125220011 title "Re: ‘Clinical course and outcomes of critically ill patients with COVID-19 infection: a systematic review’ by Serafim et al." @default.
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