Changes over time in characteristics, resource use and outcomes among ICU patients with COVID-19—A nationwide, observational study in Denmark
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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.
Originalsprog | Engelsk |
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Tidsskrift | Acta Anaesthesiologica Scandinavica |
Vol/bind | 66 |
Udgave nummer | 8 |
Sider (fra-til) | 987-995 |
Antal sider | 9 |
ISSN | 0001-5172 |
DOI | |
Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
Assistance in database development: Ann Holm Hansen and Niels Jørgensen.Assistance in data registration: Lene Friholdt Mahler, Jens Leistner, Malina Christensen, Camilla Meno Kristensen, Ali Al‐Alak, Leah Lehmann, Anna Bonde Jakobsen, Nima Moradi, Caroline Bjerregaard, Niels Christian H Østerby, Mette Minedahl Jespersen, Cecilie Bauer, Reem Zaabalawi, Mohammed Daoud, Suhayb Ahmed Ibrahim Sheekh Abdi, Nick Meyer, Lene Lund Andersen, Johan Mikkelsen, Jeppe Jensen, Birte Najbjerg Nørby, Mikkel Zacharias Bystrup Holst‐Hansen, Boris Wied, Janne Schwab, Anders Hørby Rasmussen, Emil Arnerlöv and Mathilde Lykke. This study was supported by the Danish Clinical Quality Program (RKKP). The study was partly done within the framework of the COVID STEROID trial, which was funded by the Novo Nordisk Foundation and supported by Pfizer. None of the authors declared any other conflicts of interest.
Publisher Copyright:
© 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.
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