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Observational Study
. 2022 Sep;66(8):987-995.
doi: 10.1111/aas.14113. Epub 2022 Aug 2.

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

Nicolai Haase  1 , Ronni Plovsing  2 , Steffen Christensen  3 , Lone M Poulsen  4 , Anne C Brøchner  5 , Bodil S Rasmussen  6 , Marie Helleberg  7 , Jens U S Jensen  8 , Lars P K Andersen  9 , Hanna Siegel  10 , Michael Ibsen  11 , Vibeke L Jørgensen  12 , Robert Winding  13 , Susanne Iversen  14 , Henrik P Pedersen  15 , Jacob Madsen  6 , Christoffer Sølling  16 , Ricardo S Garcia  17 , Jens Michelsen  18 , Thomas Mohr  10 , George Michagin  19 , Ulrick S Espelund  20 , Helle Bundgaard  21 , Lynge Kirkegaard  22 , Margit Smitt  23 , David L Buck  24 , Niels-Erik Ribergaard  25 , Helle S Pedersen  26 , Birgitte V Christensen  27 , Lone P Nielsen  28 , Esben Clapp  1 , Trine B Jonassen  2 , Sarah Weihe  4 , Kirstine la Cour  4 , Frederik M Nielsen  6 , Emilie K Madsen  3 , Trine N Haberlandt  5 , Nick Meier  1 , Anders Perner  1
Affiliations
Observational Study

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

Nicolai Haase et al. Acta Anaesthesiol Scand. 2022 Sep.

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.

Keywords: COVID-19; SARS-CoV-2; comorbidities; intensive care; mortality.

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Figures

FIGURE 1
FIGURE 1
Confirmed SARS‐CoV‐2 cases (panel A), vaccination status (panel A), SARS‐CoV‐2 hospital admissions (panel B) and SARS‐CoV‐2 ICU admissions in Denmark from 1 March 2020 to 30 June 2021. In September 2020, an extensive public SARS‐CoV‐2 testing programme was launched to increase the number of confirmed cases. ICU, intensive care unit; SARS‐CoV‐2, severe acute respiratory syndrome coronavirus 2.
FIGURE 2
FIGURE 2
Mortality in Danish ICU patients with COVID‐19 stratified by age (panel A) and the number of chronic comorbidities (panel B) during and after the first epidemic wave. ICU, intensive care unit.
See this image and copyright information in PMC

References

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