{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:23:44Z","timestamp":1760239424442,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T00:00:00Z","timestamp":1605916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: The COVID-19 outbreak had a major impact on healthcare systems worldwide. Our study aims to describe the characteristics and therapeutic emergency mobile service (EMS) management of patients with vital distress due to COVID-19, their in-hospital care pathway and their in-hospital outcome. Methods: This retrospective and multicentric study was conducted in the six main centers of the French Greater East region, an area heavily impacted by the pandemic. All patients requiring EMS dispatch and who were admitted straight to the intensive care unit (ICU) were included. Clinical data from their pre-hospital and hospital management were retrieved. Results: We included a total of 103 patients (78.6% male, median age 68). In the initial stage, patients were in a critical condition (median oxygen saturation was 72% (60\u201380%)). In the field, 77.7% (CI 95%: 71.8\u201388.3%) were intubated. Almost half of our population (45.6%, CI 95%: 37.1\u201356.9%) had clinical Phenotype 1 (silent hypoxemia), while the remaining half presented Phenotype 2 (acute respiratory failure). In the ICU, a great number had ARDS (77.7%, CI 95% 71.8\u201388.3% with a PaO2\/FiO2 &lt; 200). In-hospital mortality was 33% (CI 95%: 24.6\u201343.3%). The two phenotypes showed clinical and radiological differences (respiratory rate, OR = 0.98, p = 0.02; CT scan lesion extension &gt;50%, OR = 0.76, p &lt; 0.03). However, no difference was found in terms of overall in-hospital mortality (OR = 1.07, p = 0.74). Conclusion: The clinical phenotypes appear to be very distinguishable in the pre-hospital field, yet no difference was found in terms of mortality. This leads us to recommend an identical management in the initial phase, despite the two distinct presentations.<\/jats:p>","DOI":"10.3390\/jcm9113744","type":"journal-article","created":{"date-parts":[[2020,11,23]],"date-time":"2020-11-23T11:50:34Z","timestamp":1606132234000},"page":"3744","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Pre-Hospital Management of Critically Ill Patients with SARS-CoV-2 Infection: A Retrospective Multicenter Study"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9141-6439","authenticated-orcid":false,"given":"Pierrick","family":"Le Borgne","sequence":"first","affiliation":[{"name":"Emergency Department, University Hospital of Strasbourg, 1 Avenue Moli\u00e8re, 67000 Strasbourg, France"},{"name":"INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative NanoMedicine (RNM), F\u00e9d\u00e9ration de M\u00e9decine Translationnelle (FMTS), University of Strasbourg, 67000 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3419-5307","authenticated-orcid":false,"given":"Mathieu","family":"Oberlin","sequence":"additional","affiliation":[{"name":"Emergency Department, University Hospital of Strasbourg, 1 Avenue Moli\u00e8re, 67000 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3631-9633","authenticated-orcid":false,"given":"Adrien","family":"Bassand","sequence":"additional","affiliation":[{"name":"Emergency Department, University Hospital of Nancy, 29 Avenue du Mar\u00e9chal de Lattre de Tassigny, 54035 Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2527-8458","authenticated-orcid":false,"given":"Laure","family":"Abensur Vuillaume","sequence":"additional","affiliation":[{"name":"Emergency Department, Regional Hospital of Metz-Thionville, 1, All\u00e9e du Ch\u00e2teau, 57530 Ars-Laquenexy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yannick","family":"Gottwalles","sequence":"additional","affiliation":[{"name":"Emergency Department, General Hospital of Colmar, 39 Avenue de la Libert\u00e9, 68024 Colmar, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Noizet","sequence":"additional","affiliation":[{"name":"Emergency Department, Mulhouse hospital, 20 Avenue du Dr Ren\u00e9 Laennec, 68100 Mulhouse, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8490-4706","authenticated-orcid":false,"given":"St\u00e9phane","family":"Gennai","sequence":"additional","affiliation":[{"name":"Emergency Department, Reims University Hospital, 45 Rue Cognac-Jay, 51100 Reims, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0534-0122","authenticated-orcid":false,"given":"Florent","family":"Baicry","sequence":"additional","affiliation":[{"name":"Emergency Department, University Hospital of Strasbourg, 1 Avenue Moli\u00e8re, 67000 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3583-7172","authenticated-orcid":false,"given":"Deborah","family":"Jaeger","sequence":"additional","affiliation":[{"name":"Emergency Department, University Hospital of Nancy, 29 Avenue du Mar\u00e9chal de Lattre de Tassigny, 54035 Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Girerd","sequence":"additional","affiliation":[{"name":"Centre d\u2019Investigations Cliniques-1433, and INSERM U1116, F-CRIN INI-CRCT, Universit\u00e9 de Lorraine, 54000 Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Lefebvre","sequence":"additional","affiliation":[{"name":"Department of Public Health, University Hospital of Strasbourg, 1 Place de l\u2019H\u00f4pital, 67000 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0904-4600","authenticated-orcid":false,"given":"Pascal","family":"Bilbault","sequence":"additional","affiliation":[{"name":"Emergency Department, University Hospital of Strasbourg, 1 Avenue Moli\u00e8re, 67000 Strasbourg, France"},{"name":"INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative NanoMedicine (RNM), F\u00e9d\u00e9ration de M\u00e9decine Translationnelle (FMTS), University of Strasbourg, 67000 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tahar","family":"Chouihed","sequence":"additional","affiliation":[{"name":"Emergency Department, University Hospital of Nancy, 29 Avenue du Mar\u00e9chal de Lattre de Tassigny, 54035 Nancy, France"},{"name":"Centre d\u2019Investigations Cliniques-1433, and INSERM U1116, F-CRIN INI-CRCT, Universit\u00e9 de Lorraine, 54000 Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A Novel Coronavirus from Patients with Pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N. 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Anaesth."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/11\/3744\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:35:16Z","timestamp":1760178916000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/11\/3744"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,21]]},"references-count":32,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["jcm9113744"],"URL":"https:\/\/doi.org\/10.3390\/jcm9113744","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2020,11,21]]}}}