The primary aim of this study was to assess the outcome of elderly intensive care unit (ICU) patients treated during the spring and autumn COVID-19 surges in Europe. This was a prospective European observational study (the COVIP study) in ICU patients aged 70 years and older admitted with COVID-19 disease from March to December 2020 to 159 ICUs in 14 European countries. An electronic database was used to register a number of parameters including: SOFA score, Clinical Frailty Scale, co-morbidities, usual ICU procedures and survival at 90 days. The study was registered at ClinicalTrials.gov (NCT04321265). In total, 2625 patients were included, 1327 from the first and 1298 from the second surge. Median age was 74 and 75 years in surge 1 and 2, respectively. SOFA score was higher in the first surge (median 6 versus 5, p < 0.0001). The PaO2/FiO2 ratio at admission was higher during surge 1, and more patients received invasive mechanical ventilation (78% versus 68%, p < 0.0001). During the first 15 days of treatment, survival was similar during the first and the second surge. Survival was lower in the second surge after day 15 and differed after 30 days (57% vs 50%) as well as after 90 days (51% vs 40%). An unexpected, but significant, decrease in 30-day and 90-day survival was observed during the second surge in our cohort of elderly ICU patients. The reason for this is unclear. Our main concern is whether the widespread changes in practice and treatment of COVID-19 between the two surges have contributed to this increased mortality in elderly patients. Further studies are urgently warranted to provide more evidence for current practice in elderly patients. NCT04321265 , registered March 19th, 2020.

中文翻译：

---

欧洲第二次 COVID-19 激增期间危重老年患者死亡率的差异

本研究的主要目的是评估在欧洲春季和秋季 COVID-19 激增期间接受治疗的老年重症监护病房 (ICU) 患者的结果。这是一项前瞻性欧洲观察性研究（COVIP 研究），对象是 2020 年 3 月至 12 月间因 COVID-19 病入院的 70 岁及以上 ICU 患者，对象为 14 个欧洲国家的 159 个 ICU。使用电子数据库登记了许多参数，包括：SOFA 评分、临床虚弱量表、合并症、通常的 ICU 程序和 90 天的存活率。该研究已在 ClinicalTrials.gov (NCT04321265) 上注册。总共包括 2625 名患者，其中 1327 名来自第一次激增，1298 名来自第二次激增。激增 1 和 2 的中位年龄分别为 74 和 75 岁。SOFA 评分在第一次激增时更高（中位数 6 比 5，p <0.0001）。在激增 1 期间，入院时的 PaO2 / FiO2 比值更高，更多的患者接受了有创机械通气（78% 对 68%，p <0.0001）。在治疗的前 15 天，第一次和第二次激增的存活率相似。在第 15 天后的第二次激增中存活率较低，并且在 30 天后（57% 对 50%）和 90 天后（51% 对 40%）有所不同。在我们的老年 ICU 患者队列的第二次激增期间，观察到 30 天和 90 天生存率出现意外但显着的下降。原因尚不清楚。我们主要担心的是，两次激增之间 COVID-19 实践和治疗的广泛变化是否导致了老年患者死亡率的增加。迫切需要进一步的研究为老年患者的当前实践提供更多证据。NCT04321265，