Lactate is associated with mortality in very old intensive care patients suffering from COVID-19: results from an international observational study of 2860 patients

  1. Bruno, Raphael Romano
  2. Wernly, Bernhard
  3. Flaatten, Hans
  4. Fjølner, Jesper
  5. Artigas, Antonio
  6. Bollen Pinto, Bernardo
  7. Schefold, Joerg C.
  8. Binnebössel, Stephan
  9. Baldia, Philipp Heinrich
  10. Kelm, Malte
  11. Beil, Michael
  12. Sigal, Sivri
  13. van Heerden, Peter Vernon
  14. Szczeklik, Wojciech
  15. Elhadi, Muhammed
  16. Joannidis, Michael
  17. Oeyen, Sandra
  18. Zafeiridis, Tilemachos
  19. Wollborn, Jakob
  20. Arche Banzo, Maria José
  21. Fuest, Kristina
  22. Marsh, Brian
  23. Andersen, Finn H.
  24. Moreno, Rui
  25. Leaver, Susannah
  26. Boumendil, Ariane
  27. De Lange, Dylan W.
  28. Guidet, Bertrand
  29. Jung, Christian ORCID logo
  30. COVIP Study Group

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1000 Titel
  • Lactate is associated with mortality in very old intensive care patients suffering from COVID-19: results from an international observational study of 2860 patients
1000 Autor/in
  1. Bruno, Raphael Romano |
  2. Wernly, Bernhard |
  3. Flaatten, Hans |
  4. Fjølner, Jesper |
  5. Artigas, Antonio |
  6. Bollen Pinto, Bernardo |
  7. Schefold, Joerg C. |
  8. Binnebössel, Stephan |
  9. Baldia, Philipp Heinrich |
  10. Kelm, Malte |
  11. Beil, Michael |
  12. Sigal, Sivri |
  13. van Heerden, Peter Vernon |
  14. Szczeklik, Wojciech |
  15. Elhadi, Muhammed |
  16. Joannidis, Michael |
  17. Oeyen, Sandra |
  18. Zafeiridis, Tilemachos |
  19. Wollborn, Jakob |
  20. Arche Banzo, Maria José |
  21. Fuest, Kristina |
  22. Marsh, Brian |
  23. Andersen, Finn H. |
  24. Moreno, Rui |
  25. Leaver, Susannah |
  26. Boumendil, Ariane |
  27. De Lange, Dylan W. |
  28. Guidet, Bertrand |
  29. Jung, Christian |
1000 Mitwirkende/r
  1. COVIP Study Group |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-08-21
1000 Erschienen in
1000 Quellenangabe
  • 11(1):128
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s13613-021-00911-8 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8379577/ |
1000 Publikationsstatus
1000 Begutachtungsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • PURPOSE: Lactate is an established prognosticator in critical care. However, there still is insufficient evidence about its role in predicting outcome in COVID-19. This is of particular concern in older patients who have been mostly affected during the initial surge in 2020. METHODS: This prospective international observation study (The COVIP study) recruited patients aged 70 years or older (ClinicalTrials.gov ID: NCT04321265) admitted to an intensive care unit (ICU) with COVID-19 disease from March 2020 to February 2021. In addition to serial lactate values (arterial blood gas analysis), we recorded several parameters, including SOFA score, ICU procedures, limitation of care, ICU- and 3-month mortality. A lactate concentration ≥ 2.0 mmol/L on the day of ICU admission (baseline) was defined as abnormal. The primary outcome was ICU-mortality. The secondary outcomes 30-day and 3-month mortality. RESULTS: In total, data from 2860 patients were analyzed. In most patients (68%), serum lactate was lower than 2 mmol/L. Elevated baseline serum lactate was associated with significantly higher ICU- and 3-month mortality (53% vs. 43%, and 71% vs. 57%, respectively, p < 0.001). In the multivariable analysis, the maximum lactate concentration on day 1 was independently associated with ICU mortality (aOR 1.06 95% CI 1.02–1.11; p = 0.007), 30-day mortality (aOR 1.07 95% CI 1.02–1.13; p = 0.005) and 3-month mortality (aOR 1.15 95% CI 1.08–1.24; p < 0.001) after adjustment for age, gender, SOFA score, and frailty. In 826 patients with baseline lactate ≥ 2 mmol/L sufficient data to calculate the difference between maximal levels on days 1 and 2 (∆ serum lactate) were available. A decreasing lactate concentration over time was inversely associated with ICU mortality after multivariate adjustment for SOFA score, age, Clinical Frailty Scale, and gender (aOR 0.60 95% CI 0.42–0.85; p = 0.004). CONCLUSION: In critically ill old intensive care patients suffering from COVID-19, lactate and its kinetics are valuable tools for outcome prediction.
1000 Sacherschließung
lokal Intensive / Critical Care Medicine
lokal Anesthesiology
lokal Emergency Medicine
1000 Fächerklassifikation (DDC)
1000 Liste der Beteiligten
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