Changes over time in characteristics, resource use and outcomes among ICU patients with COVID‐19—A nationwide, observational study in Denmark
Nicolai Haase, Ronni R. Plovsing, Steffen Christensen, Lone Musaeus Poulsen, Anne Craveiro Brøchner, Bodil Steen Rasmussen, Marie Helleberg, Jens‐Ulrik Stæhr Jensen, Lars Peter Kloster Andersen, Hanna Siegel, Michael Ibsen, Vibeke Lind Jørgensen, Robert Winding, Susanne Iversen, Henrik Planck Pedersen, Jacob Madsen, Christoffer Sølling, Ricardo S. Garcia, Jens Michelsen, Thomas Mohr, George Michagin, Ulrick Espelund, Helle Bundgaard, L Kirkegaard, Margit Smitt, David Levarett Buck, Niels‐Erik Ribergaard, Helle Scharling Pedersen, B Christensen, Lone P. Nielsen, Esben C. Clapp, Trine B. Jonassen, Sarah Weihe, Kirstine la Cour, Frederik Mølgaard Nielsen, Emilie Kabel Madsen, Trine Haberlandt, Nick Meier, Anders Perner
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.