Clinical Scorecard: Trends in Critical Care During Five COVID-19 Waves in Pakistan: Insights from a Multi-Center Observational Study by the Pakistan Registry of Intensive Care (PRICE)

At a Glance

Key Highlights

• 1.53 million COVID-19 cases reported in Pakistan from May 2020 to March 2022.
• 30,656 fatalities recorded during five distinct waves of the pandemic.
• The PRICE registry provided near real-time data on ICU admissions and outcomes.
• Independent risk factors for mortality were identified, including the need for organ support.
• Pakistan recognized for effective pandemic management.

Guideline-Based Recommendations

Diagnosis

• Confirm COVID-19 diagnosis via reverse transcriptase polymerase chain reaction (PCR).
• Utilize ISARIC WHO Clinical Characterization Protocol for severe acute respiratory infection (SARI) symptoms.

Management

• Provide organ support as needed, including invasive mechanical ventilation and cardiovascular support.
• Implement targeted public health interventions based on real-time data.

Monitoring & Follow-up

• Track ICU admissions, organ support requirements, and mortality outcomes.
• Utilize PRICE data for ongoing assessment of critical care capacity.

Risks

• Identify independent risk factors associated with mortality in ICU patients.
• Monitor for shortages in critical care resources such as beds and ventilators.

Patient & Prescribing Data

Adults aged 18 years and older with confirmed COVID-19 admitted to ICUs.

High demand for invasive mechanical ventilation and other organ support during peak waves.

Clinical Best Practices

• Utilize a standardized data collection protocol for ICU admissions.
• Ensure timely training for data collectors and clinical leads.
• Implement evidence-based interventions based on registry data.

References

• World Health Organization (WHO)
• Pakistan Registry of Intensive Care (PRICE)
• International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC)