Journal Article > CommentaryFull Text
Lancet Global Health. 3 February 2025; Online ahead of print; DOI:10.1016/S2214-109X(24)00509-6
Godard A, Phalkey R, Shepherd S, Rossi S, Tessema MT, et al.
Lancet Global Health. 3 February 2025; Online ahead of print; DOI:10.1016/S2214-109X(24)00509-6
Journal Article > ResearchFull Text
Front Public Health. 31 August 2023; Volume 11; DOI:10.3389/fpubh.2023.1185330
Malaeb R, Haider A, Abdulateef MM, Hameed M, Daniel U, et al.
Front Public Health. 31 August 2023; Volume 11; DOI:10.3389/fpubh.2023.1185330
BACKGROUND
The Coronavirus Disease 2019 (COVID-19) pandemic has highlighted the challenges of the healthcare system in Iraq, which has limited intensive care unit beds, medical personnel, and equipment, contributing to high infection rates and mortality. The main purpose of the study was to describe the clinical characteristics, the length of Intensive Care Unit (ICU) stay, and the mortality outcomes of COVID-19 patients admitted to the ICU during the first wave and two subsequent surges, spanning from September 2020 to October 2021, in addition to identify potential risk factors for ICU mortality.
METHODS
This retrospective cohort study analyzed data from COVID-19 patients admitted to the COVID-19 ICU at Al-Kindi Ministry of Health hospital in Baghdad, Iraq, between September 2020 and October 2021.
RESULTS
The study included 936 COVID-19 patients admitted to the ICU at Al-Kindi Hospital. Results showed a high mortality rate throughout all waves, with 60% of deaths due to respiratory failure. Older age, male gender, pre-existing medical conditions, ICU procedures, and complications were associated with increased odds of ICU mortality. The study also found a decrease in the number of complications and ICU procedures between the first and subsequent waves. There was no significant difference in the length of hospital stay between patients admitted during different waves.
CONCLUSION
Despite improvements in critical care practices, the mortality rate did not significantly decrease during the second and third waves of the pandemic. The study highlights the challenges of high mortality rates among critical COVID-19 patients in low-resource settings and the importance of effective data collection to monitor clinical presentations and identify opportunities for improvement in ICU care.
The Coronavirus Disease 2019 (COVID-19) pandemic has highlighted the challenges of the healthcare system in Iraq, which has limited intensive care unit beds, medical personnel, and equipment, contributing to high infection rates and mortality. The main purpose of the study was to describe the clinical characteristics, the length of Intensive Care Unit (ICU) stay, and the mortality outcomes of COVID-19 patients admitted to the ICU during the first wave and two subsequent surges, spanning from September 2020 to October 2021, in addition to identify potential risk factors for ICU mortality.
METHODS
This retrospective cohort study analyzed data from COVID-19 patients admitted to the COVID-19 ICU at Al-Kindi Ministry of Health hospital in Baghdad, Iraq, between September 2020 and October 2021.
RESULTS
The study included 936 COVID-19 patients admitted to the ICU at Al-Kindi Hospital. Results showed a high mortality rate throughout all waves, with 60% of deaths due to respiratory failure. Older age, male gender, pre-existing medical conditions, ICU procedures, and complications were associated with increased odds of ICU mortality. The study also found a decrease in the number of complications and ICU procedures between the first and subsequent waves. There was no significant difference in the length of hospital stay between patients admitted during different waves.
CONCLUSION
Despite improvements in critical care practices, the mortality rate did not significantly decrease during the second and third waves of the pandemic. The study highlights the challenges of high mortality rates among critical COVID-19 patients in low-resource settings and the importance of effective data collection to monitor clinical presentations and identify opportunities for improvement in ICU care.
Journal Article > CommentaryFull Text
Intensive Care Med. 12 April 2023; Online ahead of print; 1-4.; DOI:10.1007/s00134-023-07042-7
Lee JS, Godard A
Intensive Care Med. 12 April 2023; Online ahead of print; 1-4.; DOI:10.1007/s00134-023-07042-7
Journal Article > CommentaryFull Text
Am J Respir Crit Care Med. 30 January 2023; Online ahead of print; DOI:10.1164/rccm.202211-2174CP
Mekontso Dessap A, Richard JCM, Baker T, Godard A, Carteaux G
Am J Respir Crit Care Med. 30 January 2023; Online ahead of print; DOI:10.1164/rccm.202211-2174CP
Journal Article > EditorialFull Text
Crit Care. 23 September 2020; Volume 24 (Issue 1); DOI:10.1186/s13054-020-03281-y
Lee JS, Godard A
Crit Care. 23 September 2020; Volume 24 (Issue 1); DOI:10.1186/s13054-020-03281-y
Journal Article > ResearchFull Text
Trans R Soc Trop Med Hyg. 8 January 2022; Online ahead of print; trab185.; DOI:10.1093/trstmh/trab185
Thomas R, Abdulateef MM, Godard A
Trans R Soc Trop Med Hyg. 8 January 2022; Online ahead of print; trab185.; DOI:10.1093/trstmh/trab185
In 2021, the burden of the coronavirus disease 2019 (COVID-19) pandemic became especially severe in low- and middle-income countries (LMICs). With high numbers of patients requiring advanced respiratory support and invasive mechanical ventilation (IMV), many ICUs were overwhelmed. This problem is particularly pronounced in LMICs, where the availability of intensive care beds may be limited. Non-invasive ventilation (NIV) has been increasingly used in COVID-19, as both a bridge to intubation as well as a definitive treatment. Use of NIV may be a feasible management strategy in settings where performing IMV is not possible on a large scale due to resource constraints. During 2020–2021, Médecins Sans Frontière helped manage a COVID-19 ICU in Baghdad, Iraq. The predominant mode of treatment was NIV. Due to a shortage of intensive care ventilators, NIV was delivered in the majority of cases by home continuous positive airway pressure machines. In total, 709 patients were admitted to the ICU during the study period with an overall mortality of 61.1%. In addition to the ventilation strategy, patients must be treated holistically, with a comprehensive package of critical care. We aim to highlight the role of NIV in this setting and summarise our experiences to assist future critical care projects during the pandemic.