The association of prior paracetamol intake with outcome of very old intensive care patients with COVID-19: results from an international prospective multicentre trial
et al., BMC Geriatrics,
Prospective study of 2,646 ICU patients ≥70 years old, showing no significant difference in mortality with acetaminophen use in the 10 days prior to ICU admission.
risk of death, 12.0% lower, OR 0.88, p = 0.20, treatment 1,166, control 1,480, adjusted per study, multivariable, day 90, RR approximated with OR.
risk of death, 14.0% lower, OR 0.86, p = 0.20, treatment 1,166, control 1,480, adjusted per study, multivariable, day 30, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Baldia et al., 27 Dec 2022, prospective, multiple countries, peer-reviewed, median age 75.0, 178 authors, trial NCT04321265 (history)
firstname.lastname@example.org (corresponding author).
Abstract: (2022) 22:1000
Baldia et al. BMC Geriatrics
The association of prior paracetamol intake
with outcome of very old intensive care patients
with COVID‑19: results from an international
prospective multicentre trial
Philipp Heinrich Baldia1, Bernhard Wernly2, Hans Flaatten3, Jesper Fjølner4, Antonio Artigas5,
Bernardo Bollen Pinto6, Joerg C. Schefold7, Malte Kelm1, Michael Beil8, Raphael Romano Bruno1,
Stephan Binnebößel1, Georg Wolff1, Ralf Erkens1, Sviri Sigal8, Peter Vernon van Heerden8, Wojciech Szczeklik9,
Muhammed Elhadi10, Michael Joannidis11, Sandra Oeyen12, Brian Marsh13, Finn H. Andersen14, Rui Moreno15,
Susannah Leaver16, Dylan W. De Lange17, Bertrand Guidet18, Christian Jung1* and COVIP study group
Background: In the early COVID-19 pandemic concerns about the correct choice of analgesics in patients with
COVID-19 were raised. Little data was available on potential usefulness or harmfulness of prescription free analgesics,
such as paracetamol. This international multicentre study addresses that lack of evidence regarding the usefulness or
potential harm of paracetamol intake prior to ICU admission in a setting of COVID-19 disease within a large, prospectively enrolled cohort of critically ill and frail intensive care unit (ICU) patients.
Methods: This prospective international observation study (The COVIP study) recruited ICU patients ≥ 70 years
admitted with COVID-19. Data on Sequential Organ Failure Assessment (SOFA) score, prior paracetamol intake within
10 days before admission, ICU therapy, limitations of care and survival during the ICU stay, at 30 days, and 3 months.
Paracetamol intake was analysed for associations with ICU-, 30-day- and 3-month-mortality using Kaplan Meier analysis. Furthermore, sensitivity analyses were used to stratify 30-day-mortality in subgroups for patient-specific characteristics using logistic regression.
Results: 44% of the 2,646 patients with data recorded regarding paracetamol intake within 10 days prior to ICU
admission took paracetamol. There was no difference in age between patients with and without paracetamol intake.
Patients taking paracetamol suffered from more co-morbidities, namely diabetes mellitus (43% versus 34%, p < 0.001),
arterial hypertension (70% versus 65%, p = 0.006) and had a higher score on Clinical Frailty Scale (CFS; IQR 2–5 versus
IQR 2–4, p < 0.001). Patients under prior paracetamol treatment were less often subjected to intubation and vasopressor use, compared to patients without paracetamol intake (65 versus 71%, p < 0.001; 63 versus 69%, p = 0.007).
Paracetamol intake was not associated with ICU-, 30-day- and 3-month-mortality, remaining true after multivariate
Department of Cardiology, Pulmonology and Vascular Medicine, Medical
Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
Full list of author information is available at the end of the article
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