• Julia L M Bels, van KuijkSander M JSMJDepartment of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, Maastricht, the Netherlands. Electronic address: sander.van.kuijk@mumc.nl., Chahinda Ghossein-Doha, Fabian H Tijssen, Rob J J van Gassel, Jeanette Tas, MaastrICCht Collaborators, Ronny M Schnabel, AriesMarcel J HMJHDepartment of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre+, Maastricht, the Netherla, van de PollMarcel C GMCGDepartment of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; Department of Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands; School of Nutriti, BergmansDennis C J JDCJJDepartment of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands. Electronic address: d.bergmans@mumc.nl., MeexSteven J RSJRDepartment of Clinical Chemistry, Central Diagnostic Laboratory, Maastricht University Medical Centre+, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Universiteitssingel 50, 6229, van MookWalther N K AWNKADepartment of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; School of Health Professions Education, Maastricht University, Universiteitssingel 60, 6229 ER Maastricht, , van der HorstIwan C CICCDepartment of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Universiteitssingel 50, 6229 ER, and Bas C T van Bussel.
• Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, the Netherlands. Electronic address: julia.bels@mumc.nl.
• J Crit Care. 2021 Apr 1; 62: 384538-45.

BackgroundThe majority of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are admitted to the Intensive Care Unit (ICU) for mechanical ventilation. The role of multi-organ failure during ICU admission as driver for outcome remains to be investigated yet.Design And SettingProspective cohort of mechanically ventilated critically ill with SARS-CoV-2 infection.Participants And Methods94 participants of the MaastrICCht cohort (21% women) had a median length of stay of 16 days (maximum of 77). After division into survivors (n = 59) and non-survivors (n = 35), we analysed 1555 serial SOFA scores using linear mixed-effects models.ResultsSurvivors improved one SOFA score point more per 5 days (95% CI: 4-8) than non-survivors. Adjustment for age, sex, and chronic lung, renal and liver disease, body-mass index, diabetes mellitus, cardiovascular risk factors, and Acute Physiology and Chronic Health Evaluation II score did not change this result. This association was stronger for women than men (P-interaction = 0.043).ConclusionsThe decrease in SOFA score associated with survival suggests multi-organ failure involvement during mechanical ventilation in patients with SARS-CoV-2. Surviving women appeared to improve faster than surviving men. Serial SOFA scores may unravel an unfavourable trajectory and guide decisions in mechanically ventilated patients with SARS-CoV-2.Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

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