Increased 30-Day Mortality in Very Old ICU Patients with COVID-19 Compared to Patients with Respiratory Failure without COVID-19

Purpose: The number of patients ≥ 80 years admitted into critical care is increasing. Coronavirus disease 2019 (COVID-19) added another challenge for clinical decisions for both admission and limitation of life-sustaining treatments (LLST). We aimed to compare the characteristics and mortality of very old critically ill patients with or without COVID-19 with a focus on LLST. Methods: Patients 80 years or older with acute respiratory failure were recruited from the VIP2 and COVIP studies. Baseline patient characteristics, interventions in intensive care unit (ICU) and outcomes (30-day survival) were recorded. COVID patients were matched to non-COVID patients based on the following factors: age (± 2 years), Sequential Organ Failure Assessment (SOFA) score (± 2 points), clinical frailty scale (± 1 point), gender and region on a 1:2 ratio. Specific ICU procedures and LLST were compared between the cohorts by means of cumulative incidence curves taking into account the competing risk of discharge and death. Results: 693 COVID patients were compared to 1393 non-COVID patients. COVID patients were younger, less frail, less severely ill with lower SOFA score, but were treated more often with invasive mechanical ventilation (MV) and had a lower 30-day survival. 404 COVID patients could be matched to 666 non-COVID patients. For COVID patients, withholding and withdrawing of LST were more frequent than for non-COVID and the 30-day survival was almost half compared to non-COVID patients. Conclusion: Very old COVID patients have a different trajectory than non-COVID patients. Whether this finding is due to a decision policy with more active treatment limitation or to an inherent higher risk of death due to COVID-19 is unclear.info:eu-repo/semantics/publishedVersio

In situ work function measurements of W, WO₃ nanostructured surfaces

Surface nanostructuring enables the fabrication of materials with highly desirable properties. Nanostructured tungsten surfaces have potential applications in solar water splitting. Exposing a polished tungsten surface to helium plasma induces various surface morphological changes. Depending on the helium ion energy, temperature, and fluence, helium clusters, helium bubbles and foam-like nanostructures develop on the tungsten surface. In this study, tungsten foam-like nanostructures were formed and/or oxidised, and then examined using X-ray and ultraviolet photoelectron spectroscopy (XPS and UPS) without breaking the vacuum. The chemical state of nanostructured W or WO3 was not modified in comparison to the pristine one. However, measuring the line width of the emitted electrons from the onset of the secondary electrons up to the Fermi edge and subtracting value from the incident photon energy, the work function acquired in situ by UPS for a nanostructured W surface increased by 0.9 eV in comparison to the pristine one. Helium ions effectively eliminated field emission sites via sputtering/implantation and thereby increased the work function. No change in work function was measured for WO3-pristine and its fuzz: the oxidation hindered the effect of helium. In contrast to the W-fuzz sample, no helium bubbles were identified in WO3-fuzz, as helium diffused out during oxidation