The association of prior paracetamol intake with outcome of very old intensive care patients with COVID-19: results from an international prospective multicentre trial

• DOI: 10.1186/s12877-022-03709-w
• Publication Date: 2022-12-27T23:02:26Z
• Authors: Philipp Heinrich ...; Bernhard Wernly; Hans Flaatten; Jesper Fjølner; Antonio Artigas; Bernardo Bollen P...; Joerg C. Schefold; Malte Kelm; Michael Beil; Raphael Romano Bruno; Stephan Binnebößel; Georg Wolff; Ralf Erkens; Sviri Sigal; Peter Vernon van ...; Wojciech Szczeklik; Muhammed Elhadi; Michael Joannidis; Sandra Oeyen; Brian Marsh; Finn H. Andersen; Rui Moreno; Susannah Leaver; Dylan W. De Lange; Bertrand Guidet; Christian Jung; ; Philipp Eller; Michael Joannidis; Dieter Mesotten; Pascal Reper; Walter Swinnen; Nicolas Serck; ELISABETH DEWAELE; Helene Brix; Jens Brushoej; Pritpal Kumar; Helene Korvenius ...; Ida Riise Balleby; Camilla Bundesen; Maria Aagaard Hansen; Stine Uhrenholt; Helle Bundgaard; Richard Innes; James Gooch; Lenka Cagova; Elizabeth Potter; Michael Reay; Miriam Davey; Mohammed Abdelsha...; Sally Humphreys; Arnaud Galbois; Cyril Charron; Caroline Hauw Ber...; Guillaume Besch; Jean-Philippe Rigaud; Julien Maizel; Michel Djibré; Philippe Burtin; Pierre Garcon; Saad Nseir; Xavier Valette; Nica Alexandru; Nathalie Marin; Marie Vaissiere; Gaëtan PLANTEFEVE; Thierry Vanderlinden; Igor Jurcisin; Buno Megarbane; Benjamin Glenn Ch...; François Dépret; Marc Garnier; Sebastien Besset; Johanna Oziel; Alexis Ferre; Stéphane Dauger; Guillaume Dumas; Bruno Goncalves; Lucie Vettoretti; Didier Thevenin; Stefan Schaller; Stefan Schaller; Muhammed Kurt; Andreas Faltlhauser; Stefan Schaller; Milena Milovanovic; Matthias Lutz; Gonxhe Shala; Hendrik Haake; Winfried Randerath; Anselm Kunstein; Patrick Meybohm; Stefan Schaller; Stephan Steiner; Eberhard Barth; Tudor Poerner; Philipp Simon; Marco Lorenz; Zouhir Dindane; Karl Friedrich Kuhn; Martin Welte; Ingo Voigt; Hans-Joachim Kabitz; Jakob Wollborn; Ulrich Goebel; Sandra Emily Stoll; Detlef Kindgen-Mi...; Simon Dubler; Christian Jung; Kristina Fuest; Michael Schuster; Antonios Papadogo...; Francesk Mulita; Nikoletta Rovina; Zoi Aidoni; EVANGELIA CHRISAN...; EUMORFIA KONDILI; Ioannis Andrianop...; Martijn Groenendijk; Mirjam Evers; Mirjam Evers; Lenneke van Lelyv...; Iwan Meynaar; Alexander Daniel ...; Marieke Zegers; Willem Dieperink; Dylan de Lange; Tom Dormans; Michael Hahn; Britt Sjøbøe; Hans Frank Strietzel; Theresa Olasveengen; Luis Romundstad; Anna Kluzik; Paweł Zatorski; Tomasz Drygalski; Jakub Klimkiewicz; Joanna Solek-past...; Dariusz Onichimowski; Miroslaw Czuczwar; Ryszard Gawda; Jan Stefaniak; Karina Stefanska-...; Ewa Zabul; Ana Isabel Pinho ...; Rui Assis; Maria de Lurdes C...; Henrique Santos; Filipe Sousa Cardoso; André Gordinho; MJosé Arche Banzo; Begoña Zalba-Etayo; PATRICIA JIMENO C...; Jesús Priego; Gemma Gomà; Teresa Maria Toma...; Susana Sancho; Aida Fernández Fe...; Eric Mayor Vázquez; Ángela Prado Mira; Mercedes Ibarz; David Iglesias; Susana Arias-Rivera; Fernando Frutos-V...; Sonia Lopez-Cuenca; Cesar Aldecoa; David Perez-Torres; Isabel Canas-Perez; Luis Tamayo-Lomas; Cristina Diaz-Rod...; Pablo Ruiz de Gop...; Nawfel Ben-Hamouda; Andrea Roberti; Yvan Fleury; Nour Abidi; Alexander Dullenkopf; Richard Pugh; Sara Smuts
• Keywords: Radboudumc 18: Healthcare improvement science RIHS: Radboud Institute for Health Sciences; Critical Care; IMPACT; paracetamol; Critical Illness; 610; 610 Medicine & health; frailty; ANALGESIA; 03 medical and health sciences; 0302 clinical medicine; Analgesics; COVID-19; Frailty; ICU; Paracetamol; 616; Medicine and Health Sciences; Humans; Prospective Studies; Analgesics, COVID-19, Frailty, ICU, Paracetamol; ELDERLY-PATIENTS; FRAILTY; Pandemics; Acetaminophen; Analgesics; Frailty; COVID-19 ; Medical and Health Sciences ; Paracetamol ; Research ; ICU ; Frailty ; Analgesics; Research; RC952-954.6; COVID-19; 3. Good health; Paracetamol; Geriatrics; ICU; SURVIVAL; analgesics

Abstract Background In the early COVID-19 pandemic concerns about correct choice of analgesics in patients with were raised. Little data was available on potential usefulness or harmfulness prescription free analgesics, such as paracetamol. This international multicentre study addresses that lack evidence regarding harm paracetamol intake prior to ICU admission a setting disease within large, prospectively enrolled cohort critically ill and frail intensive care unit (ICU) patients. Methods prospective observation (The COVIP study) recruited ≥ 70 years admitted COVID-19. Data Sequential Organ Failure Assessment (SOFA) score, 10 days before admission, therapy, limitations survival during stay, at 30 days, 3 months. Paracetamol analysed for associations ICU-, 30-day- 3-month-mortality using Kaplan Meier analysis. Furthermore, sensitivity analyses used stratify 30-day-mortality subgroups patient-specific characteristics logistic regression. Results 44% 2,646 recorded took There no difference age between without intake. Patients taking suffered from more co-morbidities, namely diabetes mellitus (43% versus 34%, p < 0.001), arterial hypertension (70% 65%, = 0.006) had higher score Clinical Frailty Scale (CFS; IQR 2–5 2–4, 0.001). under treatment less often subjected intubation vasopressor use, compared (65 71%, 0.001; 63 69%, 0.007). not associated 3-month-mortality, remaining true after multivariate adjusted Conclusion short-term 3-month mortality old, suffering Trial registration. registered ClinicalTrials.gov identifier “NCT04321265” March 25, 2020.