{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T04:14:20Z","timestamp":1743653660191,"version":"3.40.3"},"reference-count":44,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Epidemiology, ventilator management, and outcomes in patients with acute respiratory distress syndrome (ARDS) because of coronavirus disease 2019 (COVID-19) have been described extensively but have never been compared between countries. We performed an individual patient data analysis of four observational studies to compare epidemiology, ventilator management, and outcomes. We used propensity score weighting to control for confounding factors. The analysis included 6,702 patients: 1,500 from Argentina, 844 from Brazil, 975 from the Netherlands, and 3,383 from Spain. There were substantial differences in baseline characteristics between countries. There were small differences in ventilation management. Intensive care unit mortality was higher in Argentina and Brazil compared with the Netherlands and Spain (59.6% and 56.6% versus 32.1% and 34.7%; <jats:italic>P<\/jats:italic> &lt;0.001). The median number of days free from ventilation and alive at day 28 was equally low (0 [0\u20137], 0 [0\u201318], 1 [0\u201316], and 0 [0\u201316] days, respectively; <jats:italic>P<\/jats:italic> = 0.03), and the median number of days free from ventilation and alive at day 60 was higher in the Netherlands and Spain (0 [0\u201337], 0 [0\u201350], 33 [0\u201348], and 26 [0\u201348] days, respectively; <jats:italic>P<\/jats:italic> &lt;0.001). Propensity score matching confirmed the outcome differences. Thus, the outcome of COVID-19 ARDS patients in Argentina and Brazil was substantially worse compared with that of patients in the Netherlands and Spain. It is unlikely that this results from differences in case mix or ventilation management.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0257","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T18:11:02Z","timestamp":1737569462000},"page":"875-882","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology, Ventilation Management, and Outcomes in Invasively Ventilated Coronavirus Disease 2019 Patients: An Analysis of Four Observational Studies in Four Countries on Two Continents"],"prefix":"10.4269","volume":"112","author":[{"given":"Siebe G.","family":"Blok","sequence":"first","affiliation":[{"name":"Department of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Pisani","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands;"},{"name":"Mahidol Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Estenssoro","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Hospital Interzonal de Agudos General San Martin La Plata, Buenos Aires, Argentina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliana Carvalho","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, S\u00e3o Paulo, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Botta","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Motos","sequence":"additional","affiliation":[{"name":"Departement of Pulmonology, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), Hospital Cl\u00ednic de Barcelona, Barcelona, Spain;"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Respiratorias (CIBERES), Institute of Health Carlos III, Madrid, Spain;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ignacio","family":"Martin-Loeches","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Multidisciplinary Intensive Care Research Organization (MICRO), St. James\u2019 Hospital, Dublin, Ireland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoni","family":"Torres","sequence":"additional","affiliation":[{"name":"Departement of Pulmonology, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), Hospital Cl\u00ednic de Barcelona, Barcelona, Spain;"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Respiratorias (CIBERES), Institute of Health Carlos III, Madrid, Spain;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus J.","family":"Schultz","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands;"},{"name":"Mahidol Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand;"},{"name":"Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom;"},{"name":"Department of Anesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Vienna, Austria;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederique","family":"Paulus","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands;"},{"name":"Faculty of Health, ACHIEVE, Center of Applied Research, University of Applied Research, Amsterdam, The Netherlands;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M. P.","family":"van Meenen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands;"},{"name":"Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet","first-page":"1224","article-title":"The Lancet Commission on lessons for the future from the COVID-19 pandemic","volume":"400","author":"Sachs","year":"2022"},{"key":"b2","series-title":"JAMA","first-page":"1545","article-title":"Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: Early experience and forecast during an emergency response","volume":"323","author":"Grasselli","year":"2020"},{"key":"b3","series-title":"Lancet Respir Med","first-page":"506","article-title":"Intensive care management of coronavirus disease 2019 (COVID-19): Challenges and recommendations","volume":"8","author":"Phua","year":"2020"},{"key":"b4","series-title":"JAMA","first-page":"2526","article-title":"Acute respiratory distress syndrome: The Berlin definition","volume":"307","author":"Ranieri","year":"2012"},{"key":"b5","series-title":"Lancet Respir Med","first-page":"139","article-title":"Ventilation management and clinical outcomes in invasively ventilated patients with COVID-19 (PRoVENT-COVID): A national, multicentre, observational cohort study","volume":"9","author":"Botta","year":"2021"},{"key":"b6","series-title":"Arch Bronconeumol","first-page":"1","article-title":"CIBERESUCICOVID: A strategic project for a better understanding and clinical management of COVID-19 in critical patients","volume":"57","author":"Torres","year":"2021"},{"key":"b7","series-title":"J Crit Care","first-page":"154021","article-title":"Clinical characteristics, respiratory management, and determinants of oxygenation in COVID-19 ARDS: A prospective cohort study","volume":"71","author":"Estenssoro","year":"2022"},{"key":"b8","series-title":"Ann Intensive Care","first-page":"92","article-title":"Protective ventilation and outcomes of critically ill patients with COVID-19: A cohort study","volume":"11","author":"Ferreira","year":"2021"},{"key":"b9","series-title":"Lancet Glob Health","first-page":"e227","article-title":"Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: A pooled analysis of four observational studies","volume":"10","author":"Pisani","year":"2022"},{"key":"b10","series-title":"Lancet Respir Med","first-page":"627","article-title":"Geo-economic variations in epidemiology, patterns of care, and outcomes in patients with acute respiratory distress syndrome: Insights from the LUNG SAFE prospective cohort study","volume":"5","author":"Laffey","year":"2017"},{"key":"b11","series-title":"Clinics (Sao Paulo)","first-page":"e2294","article-title":"Characteristics and outcomes of patients with COVID-19 admitted to the ICU in a university hospital in S\u00e3o Paulo, Brazil\u2014Study protocol","volume":"75","author":"Ferreira","year":"2020"},{"key":"b12","series-title":"Intensive Care Med","first-page":"850","article-title":"Major candidate variables to guide personalised treatment with steroids in critically ill patients with COVID-19: CIBERESUCICOVID study","volume":"48","author":"Torres","year":"2022"},{"key":"b13","series-title":"Crit Care Med","first-page":"1772","article-title":"Statistical evaluation of ventilator-free days as an efficacy measure in clinical trials of treatments for acute respiratory distress syndrome","volume":"30","author":"Schoenfeld","year":"2002"},{"key":"b14","series-title":"J R Stat Soc Ser B","first-page":"243","article-title":"Covariate balancing propensity score","volume":"76","author":"Imai","year":"2014"},{"key":"b15","series-title":"Front Med (Lausanne)","first-page":"725265","article-title":"Association of time-varying intensity of ventilation with mortality in patients with COVID-19 ARDS: Secondary analysis of the PRoVENT-COVID study","volume":"8","author":"Schuijt","year":"2021"},{"key":"b16","series-title":"J Stat Soft","first-page":"1","article-title":"mice: Multivariate imputation by chained equations in R","volume":"45","author":"van Buuren","year":"2011"},{"key":"b17","series-title":"Epidemiology","first-page":"e45","article-title":"Web site and R package for computing e-values","volume":"29","author":"Mathur","year":"2018"},{"key":"b18","series-title":"Ann Intern Med","first-page":"268","article-title":"Sensitivity analysis in observational research: Introducing the e-value","volume":"167","author":"VanderWeele","year":"2017"},{"key":"b19","series-title":"J Bras Pneumol","first-page":"334","article-title":"Patients admitted to the ICU for acute exacerbation of COPD: Two-year mortality and functional status","volume":"37","author":"Teixeira","year":"2011"},{"key":"b20","series-title":"J Intensive Care Med","first-page":"1091","article-title":"Outcomes and resource utilization among patients admitted to the intensive care unit following acute exacerbation of chronic obstructive pulmonary disease","volume":"36","author":"Warwick","year":"2021"},{"key":"b21","series-title":"Crit Care","first-page":"268","article-title":"Implementation of sepsis bundles in public hospitals in Brazil: A prospective study with heterogeneous results","volume":"21","author":"Machado","year":"2017"},{"key":"b22","series-title":"JAMA","first-page":"1308","article-title":"Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000\u20132012","volume":"311","author":"Kaukonen","year":"2014"},{"key":"b23","series-title":"Afr J Emerg Med","first-page":"188","article-title":"Prevalence and outcome of sepsis and septic shock in intensive care units in Addis Ababa, Ethiopia: A prospective observational study","volume":"11","author":"Mulatu","year":"2021"},{"key":"b24","series-title":"Crit Care Med","first-page":"344","article-title":"Sepsis in European intensive care units: Results of the SOAP study","volume":"34","author":"Vincent","year":"2006"},{"key":"b25","series-title":"Epidemiol Infect","first-page":"315","article-title":"Epidemiology and outcome of sepsis in a tertiary-care hospital in a developing country","volume":"134","author":"Tanriover","year":"2006"},{"key":"b26","series-title":"Crit Care Explor","first-page":"e0080","article-title":"Frequency and cause of readmissions in sepsis patients presenting to a tertiary care hospital in a low middle income country","volume":"2","author":"Arshad","year":"2020"},{"key":"b27","series-title":"Crit Care Med","first-page":"1276","article-title":"Predictive validity of sepsis-3 definitions and sepsis outcomes in critically ill patients: A cohort study in 49 ICUs in Argentina","volume":"46","author":"Estenssoro","year":"2018"},{"key":"b28","series-title":"Front Med (Lausanne)","first-page":"593808","article-title":"The prevalence, risk factors, and outcomes of sepsis in critically ill patients in China: A multicenter prospective cohort study","volume":"7","author":"Wang","year":"2020"},{"key":"b29","series-title":"Indian J Pediatr","first-page":"1454","article-title":"Epidemiology and outcome of sepsis in a tertiary care PICU of Pakistan","volume":"79","author":"Khan","year":"2012"},{"key":"b30","series-title":"BMJ","first-page":"d3245","article-title":"Management of severe sepsis in patients admitted to Asian intensive care units: Prospective cohort study","volume":"342","author":"Phua","year":"2011"},{"key":"b31","series-title":"Wien Klin Wochenschr","first-page":"600","article-title":"Differences in critical care practice between an industrialized and a developing country","volume":"120","author":"D\u00fcnser","year":"2008"},{"key":"b32","series-title":"Tunis Med","first-page":"320","article-title":"Septic shock in a Tunisian intensive care unit: Mortality and predictive factors. 100 cases","volume":"83","author":"Frikha","year":"2005"},{"key":"b33","series-title":"Respir Res","first-page":"312","article-title":"Epidemiology, ventilation management and outcomes of COVID\u201319 ARDS patients versus patients with ARDS due to pneumonia in the pre-COVID era","volume":"25","author":"van der Ven","year":"2024"},{"key":"b34","series-title":"JAMA Netw Open","first-page":"e2134147-e","article-title":"Disparities in COVID-19 Outcomes by race, ethnicity, and socioeconomic status: A systematic review and meta-analysis","volume":"4","author":"Magesh","year":"2021"},{"key":"b35","series-title":"BMC Med","first-page":"404","article-title":"Allocation of intensive care resources during an infectious disease outbreak: A rapid review to inform practice","volume":"18","author":"Fiest","year":"2020"},{"key":"b36","series-title":"Crit Care Med","first-page":"1325","article-title":"Organizational issues, structure, and processes of care in 257 ICUs in Latin America: A study from the Latin America Intensive Care Network","volume":"45","author":"Estenssoro","year":"2017"},{"key":"b37","series-title":"Crit Care","first-page":"70","article-title":"Surge effects and survival to hospital discharge in critical care patients with COVID-19 during the early pandemic: A cohort study","volume":"25","author":"Dale","year":"2021"},{"key":"b38","series-title":"Int J Clin Pract","first-page":"e14426","article-title":"Time to hospitalisation, CT pulmonary involvement and in-hospital death in COVID-19 patients in an emergency medicine unit","volume":"75","author":"Marino","year":"2021"},{"key":"b39","series-title":"Lancet","first-page":"629","article-title":"Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis","volume":"399","year":"2022"},{"key":"b40","series-title":"BMC Pulm Med","first-page":"30","article-title":"Risk factors and effect on mortality of superinfections in a newly established COVID-19 respiratory sub-intensive care unit at University Hospital in Rome","volume":"23","author":"Iacovelli","year":"2023"},{"key":"b41","series-title":"Diagnostics (Basel)","first-page":"1617","article-title":"Co-infections and superinfections in COVID-19 critically ill patients are associated with CT imaging abnormalities and the worst outcomes","volume":"12","author":"Brandi","year":"2022"},{"key":"b42","series-title":"JAMA","first-page":"790","article-title":"End-of-life practices in European intensive care units: The Ethicus study","volume":"290","author":"Sprung","year":"2003"},{"key":"b43","series-title":"Intensive Care Med","first-page":"1572","article-title":"Global variability in withholding and withdrawal of life-sustaining treatment in the intensive care unit: A systematic review","volume":"41","author":"Mark","year":"2015"},{"key":"b44","series-title":"Lancet Respir Med","first-page":"465","article-title":"Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): A multicentre, prospective, observational cohort study","volume":"11","author":"Pham","year":"2023"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/112\/4\/article-p875.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/112\/4\/article-p875.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/112\/4\/article-p875.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T13:59:11Z","timestamp":1743602351000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/112\/4\/article-p875.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,2]]},"references-count":44,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.24-0257","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"type":"print","value":"0002-9637"},{"type":"electronic","value":"1476-1645"}],"subject":[],"published":{"date-parts":[[2025,4,2]]}}}