Changes over time in characteristics, resource use and outcomes among ICU patients with COVID-19—A nationwide, observational study in Denmark

Nicolai Haase*, Ronni Plovsing, Steffen Christensen, Lone M. Poulsen, Anne C. Brøchner, Bodil S. Rasmussen, Marie Helleberg, Jens U.S. Jensen, Lars P. K. Andersen, Hanna Siegel, Michael Ibsen, Vibeke L. Jørgensen, Robert Winding, Susanne Iversen, Henrik P. Pedersen, Jacob Madsen, Christoffer Sølling, Ricardo S. Garcia, Jens Michelsen, Thomas MohrGeorge Michagin, Ulrick S. Espelund, Helle Bundgaard, Lynge Kirkegaard, Margit Smitt, David L. Buck, Niels Erik Ribergaard, Helle S. Pedersen, Birgitte V. Christensen, Lone P. Nielsen, Esben Clapp, Trine B. Jonassen, Sarah Weihe, Kirstine la Cour, Frederik M. Nielsen, Emilie K. Madsen, Trine N. Haberlandt, Nick Meier, Anders Perner

*Corresponding author for this work

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Abstract

Background: Characteristics and care of intensive care unit (ICU) patients with COVID-19 may have changed during the pandemic, but longitudinal data assessing this are limited. We compared patients with COVID-19 admitted to Danish ICUs in the first wave with those admitted later. Methods: Among all Danish ICU patients with COVID-19, we compared demographics, chronic comorbidities, use of organ support, length of stay and vital status of those admitted 10 March to 19 May 2020 (first wave) versus 20 May 2020 to 30 June 2021. We analysed risk factors for death by adjusted logistic regression analysis. Results: Among all hospitalised patients with COVID-19, a lower proportion was admitted to ICU after the first wave (13% vs. 8%). Among all 1374 ICU patients with COVID-19, 326 were admitted during the first wave. There were no major differences in patient's characteristics or mortality between the two periods, but use of invasive mechanical ventilation (81% vs. 58% of patients), renal replacement therapy (26% vs. 13%) and ECMO (8% vs. 3%) and median length of stay in ICU (13 vs. 10 days) and in hospital (20 vs. 17 days) were all significantly lower after the first wave. Risk factors for death were higher age, larger burden of comorbidities (heart failure, pulmonary disease and kidney disease) and active cancer, but not admission during or after the first wave. Conclusions: After the first wave of COVID-19 in Denmark, a lower proportion of hospitalised patients with COVID-19 were admitted to ICU. Among ICU patients, use of organ support was lower and length of stay was reduced, but mortality rates remained at a relatively high level.

Original languageEnglish
JournalActa Anaesthesiologica Scandinavica
Volume66
Issue number8
Pages (from-to)987-995
ISSN0001-5172
DOIs
Publication statusPublished - Sep 2022

Bibliographical note

Publisher Copyright:
© 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

Keywords

  • comorbidities
  • COVID-19
  • intensive care
  • mortality
  • SARS-CoV-2

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