Practice of adjunctive treatments in critically ill COVID-19 patients-rational for the multicenter observational PRoAcT-COVID study in The Netherlands


<p>Background: Patients with coronavirus disease 2019 (COVID-19) may need hospitalization for supplemental oxygen, and some need intensive care unit (ICU) admission for escalation of care. Practice of adjunctive and supportive treatments remain uncertain and may vary widely between countries, within countries between hospitals, and possibly even within ICUs. We aim to investigate practice of adjunctive and supportive treatments, and their associations with outcome, in critically ill COVID-19 patients.</p><p>Methods: The 'PRactice of Adjunctive Treatments in Intensive Care Unit Patients with Coronavirus Disease 2019' (PRoAcT-COVID) study is a national, observational study to be undertaken in a large set of ICUs in The Netherlands. The PRoAcT-COVID includes consecutive ICU patients, admitted because of COVID-19 to one of the participating ICUs during a 3-month period. Daily follow-up lasts 28 days. The primary endpoint is a combination of adjunctive treatments, including types of oxygen support, ventilation, rescue therapies for hypoxemia refractory to supplementary oxygen or during invasive ventilation, other adjunctive and supportive treatments, and experimental therapies. We will also collect tracheostomy rate, duration of invasive ventilation and ventilator-free days and alive at day 28 (VFD-28), ICU and hospital length of stay, and the mortality rates in the ICU, hospital and at day 90.</p><p>Discussion: The PRoAcT-COVID study is an observational study combining high density treatment data with relevant clinical outcomes. Information on treatment practices, and their associations with outcomes in COVID-19 patients in highly and urgently needed. The results of the PRoAcT-COVID study will be rapidly available, and circulated through online presentations, such as webinars and electronic conferences, and publications in peer-reviewed journals-findings will also be presented at a dedicated website. At request, and after agreement of the PRoAcT-COVID steering committee, source data will be made available through local, regional and national anonymized datasets.</p><p>Trial registration: The PRoAcT-COVID study is registered at (study identifier NCT04719182).</p>

Reference Valk, C. M. A., Swart, P., Boers, L. S., Botta, M., Bos, L. D. J., de Abreu, M. G., Hol, L., Hollmann, M. W., Horn, J., Martin-Loeches, I., Mazzinari, G., Myatra, S. N., Nijbroek, S. G., Rosenberg, N. M., Stilma, W., Tsonas, A. M., van der Ven, W. H., Neto, A. S., Schultz, M. J., & Paulus, F. (2021). Practice of adjunctive treatments in critically ill COVID-19 patients-rational for the multicenter observational PRoAcT-COVID study in The Netherlands. Annals of Translational Medicine, 9(9), 813.
Published by  Urban Vitality 1 May 2021

Publication date

May 2021


Christel M. A. Valk
Pien Swart
Leonoor S. Boers
Michela Botta
Lieuwe D. J, Bos
Marcelo Gama de Abreu
Liselotte Hol
Markus W. Hollmann
Janneke Horn
Ignacio Martin-Loeches
Guido Mazzinari
Sheila N. Myatra
Sunny G. Nijbroek
Neeltje M. Rosenberg
Anissa M. Tsonas
Ward H. van der Ven
Ary Serpa Neto
Marcus J. Schultz
Frederique Paulus


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