Establishing the cause of Acute Respiratory Infections (ARI) at the time of presentation is difficult with currently available diagnostic approaches, resulting in unnecessary use of antibiotics in many patients and enhancing antimicrobial resistance (AMR).
In this study, we cover pathogens with proven epidemic potential such as influenza viruses and coronaviruses. Seasonal outbreaks of acute viral respiratory infections put European health services under pressure every winter, with an increased burden when new influenza variants arise. The COVID-19 pandemic has demonstrated the catastrophic impact of newly emerged viral respiratory pathogens, with huge increases in direct and indirect mortality and morbidity. The conduct of clinical research and clinical trials during the first wave of the COVID-19 pandemic in Europe has been extremely challenging. Health services were rapidly overwhelmed, with little time and no spare capacity for research.
For this reason, the primary objective of this study is to provide an infrastructure capable of rapidly implementing Randomized Controlled Trials (RCTs) and other clinical studies related to the diagnosis and treatment of ARI. The primary research objective is to compare the effectiveness of different diagnostic and therapeutic practices used routinely on clinical outcomes. The secondary objectives include descriptive analyses related to patient characteristics, complications, outcome and risk factors.
Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study
Publication date: 13 September 2022
Journal: Critical Care
Authors: Luis Felipe Reyes, Srinivas Murthy, Esteban Garcia-Gallo, Laura Merson, Elsa D. Ibáñez-Prada, Jordi Rello, Yuli V. Fuentes, Ignacio Martin-Loeches, Fernando Bozza, Sara Duque, Fabio S. Taccone, Robert A. Fowler, Christiana Kartsonaki, Bronner P. Gonçalves, Barbara Wanjiru Citarella, Diptesh Aryal, Erlina Burhan, Matthew J. Cummings, Christelle Delmas, Rodrigo Diaz, Claudia Figueiredo-Mello, Madiha Hashmi, Prasan Kumar Panda, Miguel Pedrera Jiménez, Diego Fernando Bautista Rincon, David Thomson, Alistair Nichol, John C. Marshall, Piero L. Olliaro & the ISARIC Characterization Group
The study aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries and low middle-income countries. Patients in high-income countries were more frequently treated with nasal cannulas, followed by non-invasive mechanical ventilation and invasive mechanical ventilation. In contrast, the majority of patients in lower- and middle-income countries received invasive mechanical ventilation. Higher leucocyte count, tachypnoea, and treatment in a poorer country were identified as risk factors for failure of nasal cannulas and non-invasive mechanical ventilation.