Background: The global scarcity of medical oxygen has proven to be catastrophic during the surges in COVID-19 cases over the past two years, with the heaviest burden felt in low- and middle-income countries. Despite its criticality, data and analyses of oxygen consumption, even for typical clinical cases, are missing. Consequently, planning oxygen needs, particularly with variable surges in COVID-19 cases, has presented a substantial challenge to policymakers and hospital decision-makers.
Methods: We performed a sub-analysis of the COVID-19 Critical Care Consortium database assessing the oxygen consumption requirements of COVID-19 patients admitted to intensive care units between February 2020 and October 2021. We calculated descriptive statistics for oxygen flow-rates, stratified by oxygen supplementation method, and developed a multi-state model for estimating the frequency, therapy duration, probability of transition, and number of oxygen therapy modes per patient.
Results: Overall, 12 429 patients from 35 countries received oxygen support on at least one day of their hospitalisation. Of the patients with measurable flow rates, 6142 received invasive mechanical ventilation, 838 received high-flow nasal oxygen, and 257 received both modalities. The median flow rate for mechanical ventilation was 3.2 L per minute (interquartile range (IQR) = 2.0-4.9), with a median duration of 12 days (IQR = 6-24), while the median flow rate for high-flow nasal cannula was 40 L per minute (IQR = 15-55), with a median duration of three days (IQR = 2-6).
Conclusions: Oxygen consumption among critical COVID-19 patients varies by mode of delivery (invasive ventilation vs high-flow nasal cannula), across patients, and over treatment duration. Therefore, it is essential that health facilities routinely monitor oxygen utilization to better inform oxygen delivery system design and regular supply planning.
Registration: ClinicalTrials.gov: CTG2021-01 ACTRN12620000421932.
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http://dx.doi.org/10.7189/jogh.14.05012 | DOI Listing |
Alzheimers Dement
December 2024
Tulane University, New Orleans, LA, USA.
Background: Vascular dementia (VaD), the second most common cause of dementia, is characterized by cognitive decline due to reduced cerebral blood flow and blood-brain barrier disruption. Current evidence demonstrates that not only are VaD patients at higher risk of severe COVID-19 illness and mortality, but also that pre-existing cognitive dysfunction/dementia is associated with increased COVID-19 incidence. Conversely, SARS-CoV-2 infection alone worsens dementia-related mild cognitive impairment (MCI) and increases risk of cognitive decline, supported by similar fMRI findings demonstrating hypoperfusion.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
UOC Geriatria - Disturbi Cognitivi e Demenza; AUSL Modena, Modena, Italy.
Background: Social restrictions and closures of services due to COVID-19 pandemic had a negative impact on the social inclusion and well-being of older people. In fact, older adults present risk factors both in terms of health - such as frailty or multimorbidity - and in terms of quality of life - for example institutionalization - and poor social support. The main objective is to evaluate whether social support had the role of an effect modifier on the incidence of cognitive frailty.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
CIUSSS de L'Estrie-CHUS, Sherbrooke, QC, Canada.
Background: In the province of Quebec, Canada, primary care management of Alzheimer's disease is provided by the Family Medicine Group with the support of the Ministerial Initiative on Alzheimer's Disease and the collaboration of specialized memory clinics. The COVID years have severely strained health resources in all areas, including cognitive intervention resources. We describe the reorganization of regional support in the Eastern Townships.
View Article and Find Full Text PDFClin Nurs Res
January 2025
Institute of Human Genetics, Faculty of Medicine, University of Belgrade, Serbia.
The hypoxia-inducible factor-1 alpha (HIF-1 alpha) is a major regulator of adaptive response to hypoxia, common in patients with severe coronavirus disease 2019 (COVID-19). In addition, HIF-1 alpha regulates the expression of the most important proteins necessary for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of cells. The study included 129 hospitalized COVID-19 patients.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Davos Alzheimer's Collaborative, Wayne, PA, USA.
Background: Cognitive impairment is frequently undetected or undiagnosed in the early stages. To increase the rates of detecting cognitive impairment, the Early Detection program of the Davos Alzheimer's Collaborative System Preparedness (DAC-SP) implemented digital cognitive assessments (DCA) in primary care and other non-specialty settings.
Methods: The DAC-SP Early Detection program was initiated in 2021 in seven healthcare systems across six countries.
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