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 M Poulsen; Anne C Brøchner; Bodil S Rasmussen; Marie Helleberg; Jens U S Jensen; Lars P K Andersen; Hanna Siegel; Michael Ibsen; Vibeke L Jørgensen; Robert Winding; Susanne Iversen; Henrik P Pedersen; Jacob Madsen; Christoffer Sølling; Ricardo S Garcia; Jens Michelsen; Thomas Mohr; George Michagin; Ulrick S Espelund; Helle Bundgaard; Lynge Kirkegaard; Margit Smitt; David L Buck; Niels-Erik Ribergaard; Helle S Pedersen; Birgitte V Christensen; Lone P Nielsen; Esben Clapp; Trine B Jonassen; Sarah Weihe; Kirstine la Cour; Frederik M Nielsen; Emilie K Madsen; Trine N 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 M Poulsen, Anne C Brøchner, Bodil S Rasmussen, Marie Helleberg, Jens U S Jensen, Lars P K Andersen, Hanna Siegel, Michael Ibsen, Vibeke L Jørgensen, Robert Winding, Susanne Iversen, Henrik P Pedersen, Jacob Madsen, Christoffer Sølling, Ricardo S Garcia, Jens Michelsen, Thomas MohrGeorge Michagin, Ulrick S Espelund, Helle Bundgaard, Lynge Kirkegaard, Margit Smitt, David L Buck, Niels-Erik Ribergaard, Helle S Pedersen, Birgitte V Christensen, Lone P Nielsen, Esben Clapp, Trine B Jonassen, Sarah Weihe, Kirstine la Cour, Frederik M Nielsen, Emilie K Madsen, Trine N Haberlandt, Nick Meier, Anders Perner

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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.

Original language	English
Journal	Acta Anaesthesiologica Scandinavica
Volume	66
Issue number	8
Pages (from-to)	987-995
Number of pages	9
ISSN	0001-5172
DOIs	https://doi.org/10.1111/aas.14113
Publication status	Published - Sept 2022

Bibliographical note

Keywords

COVID-19
SARS-CoV-2
comorbidities
intensive care
mortality
Denmark/epidemiology
Intensive Care Units
Pandemics
Hospital Mortality
Humans
Retrospective Studies
COVID-19/therapy

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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. Advance online publication. https://doi.org/10.1111/aas.14113

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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 = "COVID-19, SARS-CoV-2, comorbidities, intensive care, mortality, Denmark/epidemiology, Intensive Care Units, Pandemics, Hospital Mortality, Humans, Retrospective Studies, COVID-19/therapy",

author = "Nicolai Haase and Ronni Plovsing and Steffen Christensen and Poulsen, {Lone M} and Br{\o}chner, {Anne C} and Rasmussen, {Bodil S} and Marie Helleberg and Jensen, {Jens U S} and Andersen, {Lars P K} and Hanna Siegel and Michael Ibsen and J{\o}rgensen, {Vibeke L} and Robert Winding and Susanne Iversen and Pedersen, {Henrik P} and Jacob Madsen and Christoffer S{\o}lling and Garcia, {Ricardo S} and Jens Michelsen and Thomas Mohr and George Michagin and Espelund, {Ulrick S} and Helle Bundgaard and Lynge Kirkegaard and Margit Smitt and Buck, {David L} and Niels-Erik Ribergaard and Pedersen, {Helle S} and Christensen, {Birgitte V} and Nielsen, {Lone P} and Esben Clapp and Jonassen, {Trine B} and Sarah Weihe and {la Cour}, Kirstine and Nielsen, {Frederik M} and Madsen, {Emilie K} and Haberlandt, {Trine N} 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",

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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, vol. 66, no. 8, pp. 987-995. https://doi.org/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. / Haase, Nicolai; Plovsing, Ronni; Christensen, Steffen et al.
In: Acta Anaesthesiologica Scandinavica, Vol. 66, No. 8, 09.2022, p. 987-995.

Research output: Contribution to journal › Journal article › Research › peer-review

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 M

AU - Brøchner, Anne C

AU - Rasmussen, Bodil S

AU - Helleberg, Marie

AU - Jensen, Jens U S

AU - Andersen, Lars P K

AU - Siegel, Hanna

AU - Ibsen, Michael

AU - Jørgensen, Vibeke L

AU - Winding, Robert

AU - Iversen, Susanne

AU - Pedersen, Henrik P

AU - Madsen, Jacob

AU - Sølling, Christoffer

AU - Garcia, Ricardo S

AU - Michelsen, Jens

AU - Mohr, Thomas

AU - Michagin, George

AU - Espelund, Ulrick S

AU - Bundgaard, Helle

AU - Kirkegaard, Lynge

AU - Smitt, Margit

AU - Buck, David L

AU - Ribergaard, Niels-Erik

AU - Pedersen, Helle S

AU - Christensen, Birgitte V

AU - Nielsen, Lone P

AU - Clapp, Esben

AU - Jonassen, Trine B

AU - Weihe, Sarah

AU - la Cour, Kirstine

AU - Nielsen, Frederik M

AU - Madsen, Emilie K

AU - Haberlandt, Trine N

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 - COVID-19

KW - SARS-CoV-2

KW - comorbidities

KW - intensive care

KW - mortality

KW - Denmark/epidemiology

KW - Intensive Care Units

KW - Pandemics

KW - Hospital Mortality

KW - Humans

KW - Retrospective Studies

KW - COVID-19/therapy

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U2 - 10.1111/aas.14113

DO - 10.1111/aas.14113

M3 - Journal 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

Bibliographical note

Keywords

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