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Scientific article
Open access
English

What have we learned from the first to the second wave of COVID-19 pandemic ? An international survey from the ESCMID Study Group for Infection in the Elderly (ESGIE) group

Publication date2022-02
First online date2021-11-13
Abstract

The purpose of this survey is to explore changes in the management of COVID-19 during the first versus the second wave, with particular emphasis on therapies, antibiotic prescriptions, and elderly care. An internet-based questionnaire survey was distributed to European Society of Clinical Microbiology and Infectious Diseases (ESCMID) members. Therapeutic approach to patients with mild-to-moderate (PiO2/FiO2200-350) and severe (PiO2/FiO2 < 200) COVID-19, antibiotic use, and reasons for excluding patients from the intensive care unit (ICU) were investigated. A total of 463 from 21 countries participated in the study. Most representatives were infectious disease specialists (68.3%). During the second wave of pandemic, physicians abandoned the use of hydroxychloroquine, lopinavir/ritonavir, and azithromycin in favor of dexamethasone, low-molecular weight heparin (LMWH), and remdesivir in mild-to-moderate COVID-19. In critically ill patients, we detected an increased use of high-dose steroids (51%) and a decrease in tocilizumab use. The use of antibiotics at hospital admission decreased but remained high in the second wave. Age was reported to be a main consideration for exclusion of patients from ICU care by 25% of responders; a third reported that elderly were not candidates for ICU admission in their center. The decision to exclude patients from ICU care was based on the individual decision of an intensivist in 59.6% of cases. The approach of physicians to COVID-19 changed over time following evidence accumulation and guidelines. Antibiotic use at hospital admission and decision to exclude patients from ICU care remain critical aspects that should be better investigated and harmonized among clinicians.

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Keywords
  • Antibiotics
  • COVID-19
  • Elderly
  • Intensive care unit
  • Long COVID
  • SARS-CoV-2
  • COVID-19 / drug therapy
  • COVID-19 / epidemiology
  • Drug Combinations
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Intensive Care Units
  • Lopinavir
  • Pandemics
  • Ritonavir
  • Surveys and Questionnaires
Citation (ISO format)
TISEO, Giusy et al. What have we learned from the first to the second wave of COVID-19 pandemic ? An international survey from the ESCMID Study Group for Infection in the Elderly (ESGIE) group. In: European journal of clinical microbiology & infectious diseases, 2022, vol. 41, n° 2, p. 281–288. doi: 10.1007/s10096-021-04377-1
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Article (Published version)
accessLevelPublic
Identifiers
ISSN of the journal0934-9723
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Technical informations

Creation03/15/2022 12:11:33 PM
First validation04/29/2024 9:36:04 AM
Update time04/29/2024 9:36:04 AM
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