TY - JOUR
T1 - Changes over time in characteristics, resource use and outcomes among ICU patients with COVID-19 - a nationwide, observational study in Denmark
AU - Haase, Nicolai
AU - Plovsing, Ronni
AU - Christensen, Steffen
AU - Poulsen, Lone Musaeus
AU - Brøchner, Anne Craveiro
AU - Rasmussen, Bodil Steen
AU - Helleberg, Marie
AU - Jensen, Jens Ulrik Staehr
AU - Andersen, Lars Peter Kloster
AU - Siegel, Hanna
AU - Ibsen, Michael
AU - Jørgensen, Vibeke Lind
AU - Winding, Robert
AU - Iversen, Susanne
AU - Pedersen, Henrik Planck
AU - Madsen, Jacob
AU - Sølling, Christoffer
AU - Garcia, Ricardo Sanchez
AU - Michelsen, Jens
AU - Mohr, Thomas
AU - Michagin, George
AU - Espelund, Ulrick Skipper
AU - Bundgaard, Helle
AU - Kirkegaard, Lynge
AU - Smitt, Margit
AU - Buck, David Levarett
AU - Ribergaard, Niels-Erik
AU - Pedersen, Helle Scharling
AU - Christensen, Birgitte Viebaek
AU - Nielsen, Lone Pia
AU - Clapp, Esben
AU - Jonassen, Trine Bak
AU - Weihe, Sarah
AU - la Cour, Kirstine
AU - Nielsen, Frederik Mølgaard
AU - Madsen, Emilie Kabel
AU - Haberlandt, Trine Nørskov
AU - Meier, Nick
AU - Perner, Anders
N1 - This article is protected by copyright. All rights reserved.
PY - 2022/9
Y1 - 2022/9
N2 - 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.
AB - 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.
KW - COVID-19/therapy
KW - Denmark/epidemiology
KW - Hospital Mortality
KW - Humans
KW - Intensive Care Units
KW - Pandemics
KW - Retrospective Studies
KW - SARS-CoV-2
KW - COVID-19
KW - comorbidities
KW - intensive care
KW - mortality
UR - http://www.scopus.com/inward/record.url?scp=85135270856&partnerID=8YFLogxK
U2 - 10.1111/aas.14113
DO - 10.1111/aas.14113
M3 - Journal article
C2 - 35781689
SN - 0001-5172
VL - 66
SP - 987
EP - 995
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
IS - 8
M1 - 14113
ER -