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

Nicolai Haase; Ronni Plovsing; Steffen Christensen; Lone Musaeus Poulsen; Anne Craveiro Brøchner; Bodil Steen Rasmussen; Marie Helleberg; Jens Ulrik Staehr Jensen; Lars Peter Kloster Andersen; Hanna Siegel; Michael Ibsen; Vibeke Lind Jørgensen; Robert Winding; Susanne Iversen; Henrik Planck Pedersen; Jacob Madsen; Christoffer Sølling; Ricardo Sanchez Garcia; Jens Michelsen; Thomas Mohr; George Michagin; Ulrick Skipper Espelund; Helle Bundgaard; Lynge Kirkegaard; Margit Smitt; David Levarett Buck; Niels-Erik Ribergaard; Helle Scharling Pedersen; Birgitte Viebaek Christensen; Lone Pia Nielsen; Esben Clapp; Trine Bak Jonassen; Sarah Weihe; Kirstine la Cour; Frederik Mølgaard Nielsen; Emilie Kabel Madsen; Trine Nørskov Haberlandt; Nick Meier; Anders Perner

doi:10.1111/aas.14113

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

Nicolai Haase^*
, Ronni Plovsing
, Steffen Christensen
, Lone Musaeus Poulsen
, Anne Craveiro Brøchner
, Bodil Steen Rasmussen
, Marie Helleberg
, Jens Ulrik Staehr Jensen
, Lars Peter Kloster Andersen
, Hanna Siegel
, Michael Ibsen
, Vibeke Lind Jørgensen
, Robert Winding
, Susanne Iversen
, Henrik Planck Pedersen
, Jacob Madsen
, Christoffer Sølling
, Ricardo Sanchez Garcia
, Jens Michelsen
, Thomas Mohr

George Michagin, Ulrick Skipper Espelund, Helle Bundgaard, Lynge Kirkegaard, Margit Smitt, David Levarett Buck, Niels-Erik Ribergaard, Helle Scharling Pedersen, Birgitte Viebaek Christensen, Lone Pia Nielsen, Esben Clapp, Trine Bak Jonassen, Sarah Weihe, Kirstine la Cour, Frederik Mølgaard Nielsen, Emilie Kabel Madsen, Trine Nørskov Haberlandt, Nick Meier, Anders Perner

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift › Artikel › Forskning › peer review

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.

Originalsprog	Engelsk
Sider (fra-til)	987-995
Antal sider	9
Tidsskrift	Acta Anaesthesiologica Scandinavica
Vol/bind	66
Udgave nummer	8
Tidlig onlinedato	3 jul. 2022
DOI	https://doi.org/10.1111/aas.14113
Status	Udgivet - sep. 2022

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10.1111/aas.14113

Citationsformater

Haase, N., Plovsing, R., Christensen, S., Poulsen, L. M., Brøchner, A. C., Rasmussen, B. S., Helleberg, M., Jensen, J. U. S., Andersen, L. P. K., Siegel, H., Ibsen, M., Jørgensen, V. L., Winding, R., Iversen, S., Pedersen, H. P., Madsen, J., Sølling, C., Garcia, R. S., Michelsen, J., ... Perner, A. (2022). Changes over time in characteristics, resource use and outcomes among ICU patients with COVID-19 - a nationwide, observational study in Denmark. Acta Anaesthesiologica Scandinavica, 66(8), 987-995. https://doi.org/10.1111/aas.14113

@article{2c0b19895a3040f4b8b7a891dc121b14,

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

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 = "comorbidities, COVID-19, intensive care, mortality, SARS-CoV-2",

author = "Nicolai Haase and Ronni Plovsing and Steffen Christensen and Poulsen, \{Lone Musaeus\} and Br{\o}chner, \{Anne Craveiro\} and Rasmussen, \{Bodil Steen\} and Marie Helleberg and Jensen, \{Jens Ulrik Staehr\} and Andersen, \{Lars Peter Kloster\} and Hanna Siegel and Michael Ibsen and J{\o}rgensen, \{Vibeke Lind\} and Robert Winding and Susanne Iversen and Pedersen, \{Henrik Planck\} and Jacob Madsen and Christoffer S{\o}lling and Garcia, \{Ricardo Sanchez\} and Jens Michelsen and Thomas Mohr and George Michagin and Espelund, \{Ulrick Skipper\} and Helle Bundgaard and Lynge Kirkegaard and Margit Smitt and Buck, \{David Levarett\} and Niels-Erik Ribergaard and Pedersen, \{Helle Scharling\} and Christensen, \{Birgitte Viebaek\} and Nielsen, \{Lone Pia\} and Esben Clapp and Jonassen, \{Trine Bak\} and Sarah Weihe and \{la Cour\}, Kirstine and Nielsen, \{Frederik M{\o}lgaard\} and Madsen, \{Emilie Kabel\} and Haberlandt, \{Trine N{\o}rskov\} and Nick Meier and Anders Perner",

note = "{\textcopyright} 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley \& Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.",

year = "2022",

month = sep,

doi = "10.1111/aas.14113",

language = "English",

volume = "66",

pages = "987--995",

journal = "Acta Anaesthesiologica Scandinavica",

issn = "0001-5172",

publisher = "Blackwell Munksgaard",

number = "8",

}

Haase, N, Plovsing, R, Christensen, S, Poulsen, LM, Brøchner, AC, Rasmussen, BS, Helleberg, M, Jensen, JUS, Andersen, LPK, Siegel, H, Ibsen, M, Jørgensen, VL, Winding, R, Iversen, S , Pedersen, HP, Madsen, J, Sølling, C, Garcia, RS, Michelsen, J, Mohr, T, Michagin, G, Espelund, US, Bundgaard, H, Kirkegaard, L, Smitt, M, Buck, DL, Ribergaard, N-E, Pedersen, HS, Christensen, BV, Nielsen, LP, Clapp, E, Jonassen, TB, Weihe, S, la Cour, K, Nielsen, FM, Madsen, EK, Haberlandt, TN, Meier, N & Perner, A 2022, 'Changes over time in characteristics, resource use and outcomes among ICU patients with COVID-19 - a nationwide, observational study in Denmark', Acta Anaesthesiologica Scandinavica, bind 66, nr. 8, s. 987-995. https://doi.org/10.1111/aas.14113

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

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 - comorbidities

KW - COVID-19

KW - intensive care

KW - mortality

KW - SARS-CoV-2

U2 - 10.1111/aas.14113

DO - 10.1111/aas.14113

M3 - Article

C2 - 35781689

SN - 0001-5172

VL - 66

SP - 987

EP - 995

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

IS - 8

ER -

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

Abstract

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