The following is a summary of “Regional differences in triage decisions affect hospital mortality among frail COVID-19 patients in the COvid MEdicaTion study,” published in the February 2025 issue of Infectious Disease by Minnema et al. 

The scarcity of intensive care unit (ICU) beds during the COVID-19 pandemic resulted in numerous national and international guidelines for ICU triage, with regional differences potentially influencing decision-making.  

Researchers conducted a retrospective study to examine whether regional differences in ICU admission, as a surrogate for triage decisions, impacted in-hospital mortality in patients with COVID-19.  

They included adults hospitalized for COVID-19 between March 2020 and July 2020 in 11 European countries, categorized into north and south regions in a COvid MEdicaTion study (COMET). Data on patients’ characteristics, prescribed medications, clinical features, and Clinical Frailty Scale (CFS) were collected. Logistic regression analyses, stratified by frailty, were used to assess the effects of region on ICU admission and in-hospital mortality.  

The results showed frail individuals had a higher risk for ICU admission in southern countries compared to northern ones (Odds Ratio (OR): 1.64; 95% Confidence Interval (CI): 1.10–2.46), while fit individuals had a similar risk for ICU admission in both regions (OR: 0.75; 95% CI: 0.55–1.01). No significant difference in in-hospital mortality was observed between northern and southern countries for either frail (OR: 1.11; 95% CI: 0.74–1.66) or fit individuals (OR: 0.82; 95% CI: 0.52–1.29).  

Investigators concluded that despite variations in ICU admission rates for frail patients between northern and southern countries, no difference in in-hospital mortality was observed. 

Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-10540-2