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A descriptive study of the surge response and outcomes of ICU patients with COVID-19 during first wave in Nordic countries

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  • Michelle S Chew
  • Salla Kattainen
  • Nicolai Haase
  • Eirik A Buanes
  • Linda B Kristinsdottir
  • Kristin Hofsø
  • Jon Henrik Laake
  • Reidar Kvåle
  • Johanna Hästbacka
  • Matti Reinikainen
  • Stepani Bendel
  • Tero Varpula
  • Sten Walther
  • Anders Perner
  • Hans K Flaatten
  • Martin I Sigurdsson
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BACKGROUND: We sought to provide a description of surge response strategies and characteristics, clinical management and outcomes of patients with severe COVID-19 in the intensive care unit (ICU) during the first wave of the pandemic in Denmark, Finland, Iceland, Norway and Sweden.

METHODS: Representatives from the national ICU registries for each of the five countries provided clinical data and a description of the strategies to allocate ICU resources and increase the ICU capacity during the pandemic. All adult patients admitted to the ICU for COVID-19 disease during the first wave of COVID-19 were included. The clinical characteristics, ICU management and outcomes of individual countries were described with descriptive statistics.

RESULTS: Most countries more than doubled their ICU capacity during the pandemic. For patients positive for SARS-CoV-2, the ratio of requiring ICU admission for COVID-19 varied substantially (1.6%-6.7%). Apart from age (proportion of patients aged 65 years or over between 29% and 62%), baseline characteristics, chronic comorbidity burden and acute presentations of COVID-19 disease were similar among the five countries. While utilization of invasive mechanical ventilation was high (59%-85%) in all countries, the proportion of patients receiving renal replacement therapy (7%-26%) and various experimental therapies for COVID-19 disease varied substantially (e.g. use of hydroxychloroquine 0%-85%). Crude ICU mortality ranged from 11% to 33%.

CONCLUSION: There was substantial variability in the critical care response in Nordic ICUs to the first wave of COVID-19 pandemic, including usage of experimental medications. While ICU mortality was low in all countries, the observed variability warrants further attention.

OriginalsprogEngelsk
TidsskriftActa Anaesthesiologica Scandinavica
Vol/bind66
Udgave nummer1
Sider (fra-til)56-64
Antal sider9
ISSN0001-5172
DOI
StatusUdgivet - jan. 2022

Bibliografisk note

© 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

ID: 71679341