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. 2023 Oct 18;23(3):308-319.
doi: 10.51893/2021.3.OA8. eCollection 2021 Sep 6.

Comparison of baseline characteristics, treatment and celinical outcomes of critically ill COVID-19 patients admitted in the first and second waves in Australia

Aidan J C Burrell  1   2 , Ary Serpa Neto  1 , Tessa Broadley  1 , Tony Trapani  1 , Husna Begum  1 , Lewis T Campbell  3   4 , Allen C Cheng  5   6 , Winston Cheung  7 , D James Cooper  1   2 , Simon J Erickson  8 , Craig J French  1   9 , John M Kaldor  10 , Edward Litton  11   12 , Srinivas Murthy  13 , Richard E McAllister  14 , Alistair D Nichol  1   2 , Annamaria Palermo  11 , Mark P Plummer  15 , Mahesh Ramanan  16 , Benjamin A J Reddi  17   18 , Claire Reynolds  19 , Steve A Webb  1   12 , Andrew A Udy  1   2 ; SPRINT SARI Australia Investigators
Affiliations

Comparison of baseline characteristics, treatment and celinical outcomes of critically ill COVID-19 patients admitted in the first and second waves in Australia

Aidan J C Burrell et al. Crit Care Resusc. .

Abstract

Objective: To report longitudinal differences in baseline characteristics, treatment, and outcomes in patients with coronavirus disease 2019 (COVID-19) admitted to intensive care units (ICUs) between the first and second waves of COVID-19 in Australia. Design, setting and participants: SPRINT-SARI Australia is a multicentre, inception cohort study enrolling adult patients with COVID-19 admitted to participating ICUs. The first wave of COVID-19 was from 27 February to 30 June 2020, and the second wave was from 1 July to 22 October 2020. Results: A total of 461 patients were recruited in 53 ICUs across Australia; a higher number were admitted to the ICU during the second wave compared with the first: 255 (55.3%) versus 206 (44.7%). Patients admitted to the ICU in the second wave were younger (58.0 v 64.0 years; P = 0.001) and less commonly male (68.9% v 60.0%; P = 0.045), although Acute Physiology and Chronic Health Evaluation (APACHE) II scores were similar (14 v 14; P = 0.998). High flow oxygen use (75.2% v 43.4%; P < 0.001) and non-invasive ventilation (16.5% v 7.1%; P = 0.002) were more common in the second wave, as was steroid use (95.0% v 30.3%; P < 0.001). ICU length of stay was shorter (6.0 v 8.4 days; P = 0.003). In-hospital mortality was similar (12.2% v 14.6%; P = 0.452), but observed mortality decreased over time and patients were more likely to be discharged alive earlier in their ICU admission (hazard ratio, 1.43; 95% CI, 1.13-1.79; P = 0.002). Conclusion: During the second wave of COVID-19 in Australia, ICU length of stay and observed mortality decreased over time. Multiple factors were associated with this, including changes in clinical management, the adoption of new evidence-based treatments, and changes in patient demographic characteristics but not illness severity.

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Conflict of interest statement

No relevant disclosures.

Figures

Figure 1
Figure 1
Cumulative number of patients admitted to the intensive care unit (ICU) due to coronavirus disease 2019 (COVID-19) in the first and second waves
Figure 2
Figure 2
Coexisting disorders, symptoms, interventions and complications in patients admitted to the intensive care unit (ICU) due to coronavirus disease 2019 (COVID-19) in the first and second waves*
Figure 3
Figure 3
Cumulative incidence plot of intensive care unit (ICU) and hospital discharge according to the phase of the study*
Figure 4
Figure 4
Exponentially weighted moving average (EWMA)*
See this image and copyright information in PMC

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