Characteristics, interventions and longer-term outcomes of COVID-19 ICU patients in Denmark - a nationwide, observational study

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 Jørgensen; Robert Winding; Susanne Iversen; Henrik Planck Pedersen; Jacob Madsen; Christoffer Sølling; Ricardo Sanchez Garcia; Jens Michelsen; Thomas Mohr; Anne Mannering; Ulrick Skipper Espelund; Helle Bundgaard; Lynge Kirkegaard; Margit Smitt; David Levarett Buck; Niels-Erik Ribergaard; Helle Scharling Pedersen; Birgitte Viebaek Christensen; Anders Perner

doi:10.1111/aas.13701

Characteristics, interventions and longer-term outcomes of COVID-19 ICU patients in Denmark - a nationwide, observational study

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 Jørgensen, Robert Winding, Susanne Iversen, Henrik Planck Pedersen, Jacob Madsen, Christoffer Sølling, Ricardo Sanchez Garcia, Jens Michelsen, Thomas MohrAnne Mannering, Ulrick Skipper Espelund, Helle Bundgaard, Lynge Kirkegaard, Margit Smitt, David Levarett Buck, Niels-Erik Ribergaard, Helle Scharling Pedersen, Birgitte Viebaek Christensen, Anders Perner

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Abstract

BACKGROUND: Most data on intensive care unit (ICU) patients with COVID-19 originate in selected populations from stressed healthcare systems with shorter term follow-up. We present characteristics, interventions and longer term outcomes of the entire, unselected cohort of all ICU patients with COVID-19 in Denmark where the ICU capacity was not exceeded.

METHODS: We identified all patients with SARS-CoV-2 admitted to any Danish ICU from 10 March to 19 May 2020 and registered demographics, chronic comorbidities, use of organ support, length of stay, and vital status from patient files. Risk factors for death were analyzed using adjusted Cox regression analysis.

RESULTS: There were 323 ICU patients with confirmed COVID-19. Median age was 68 years, 74% were men, 50% had hypertension, 21% diabetes, and 20% chronic pulmonary disease; 29% had no chronic comorbidity. Invasive mechanical ventilation was used in 82%, vasopressors in 83%, renal replacement therapy in 26%, and extra corporeal membrane oxygenation in 8%. ICU stay was median 13 days (IQR 6-22) and hospital stay 19 days (11-30). Median follow-up was 79 days. At end of follow-up, 118 had died (37%), 15 (4%) were still in hospital hereof 4 in ICU as of 16 June 2020. Risk factors for mortality included male gender, age, chronic pulmonary disease, active cancer, and number of co-morbidities.

CONCLUSIONS: In this nationwide, population-based cohort of ICU patients with COVID-19, longer term survival was high despite high age and substantial use of organ support. Male gender, age, and chronic co-morbidities, in particular chronic pulmonary disease, were associated with increased risk of death.

Original language	English
Journal	Acta Anaesthesiologica Scandinavica
Volume	65
Issue number	1
Pages (from-to)	68-75
Number of pages	8
ISSN	0001-5172
DOIs	https://doi.org/10.1111/aas.13701
Publication status	Published - Jan 2021

Bibliographical note

Keywords

COVID-19
SARS-CoV-2
comorbidities
intensive care
mortality

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Haase et al. (2020) Accepted ArticleAccepted author manuscript, 8.82 MB

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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., Winding, R., Iversen, S., Pedersen, H. P., Madsen, J., Sølling, C., Garcia, R. S., Michelsen, J., ... Perner, A. (2021). Characteristics, interventions and longer-term outcomes of COVID-19 ICU patients in Denmark - a nationwide, observational study. Acta Anaesthesiologica Scandinavica, 65(1), 68-75. Advance online publication. https://doi.org/10.1111/aas.13701

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title = "Characteristics, interventions and longer-term outcomes of COVID-19 ICU patients in Denmark - a nationwide, observational study",

abstract = "BACKGROUND: Most data on intensive care unit (ICU) patients with COVID-19 originate in selected populations from stressed healthcare systems with shorter term follow-up. We present characteristics, interventions and longer term outcomes of the entire, unselected cohort of all ICU patients with COVID-19 in Denmark where the ICU capacity was not exceeded.METHODS: We identified all patients with SARS-CoV-2 admitted to any Danish ICU from 10 March to 19 May 2020 and registered demographics, chronic comorbidities, use of organ support, length of stay, and vital status from patient files. Risk factors for death were analyzed using adjusted Cox regression analysis.RESULTS: There were 323 ICU patients with confirmed COVID-19. Median age was 68 years, 74% were men, 50% had hypertension, 21% diabetes, and 20% chronic pulmonary disease; 29% had no chronic comorbidity. Invasive mechanical ventilation was used in 82%, vasopressors in 83%, renal replacement therapy in 26%, and extra corporeal membrane oxygenation in 8%. ICU stay was median 13 days (IQR 6-22) and hospital stay 19 days (11-30). Median follow-up was 79 days. At end of follow-up, 118 had died (37%), 15 (4%) were still in hospital hereof 4 in ICU as of 16 June 2020. Risk factors for mortality included male gender, age, chronic pulmonary disease, active cancer, and number of co-morbidities.CONCLUSIONS: In this nationwide, population-based cohort of ICU patients with COVID-19, longer term survival was high despite high age and substantial use of organ support. Male gender, age, and chronic co-morbidities, in particular chronic pulmonary disease, were associated with increased risk of death.",

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

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 Vibeke J{\o}rgensen 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 Anne Mannering 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 Anders Perner",

note = "{\textcopyright} 2020 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.",

year = "2021",

month = jan,

doi = "10.1111/aas.13701",

language = "English",

volume = "65",

pages = "68--75",

journal = "Acta Anaesthesiologica Scandinavica",

issn = "0001-5172",

publisher = "Wiley-Blackwell",

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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, V, Winding, R, Iversen, S, Pedersen, HP, Madsen, J, Sølling, C, Garcia, RS, Michelsen, J, Mohr, T, Mannering, A, Espelund, US, Bundgaard, H, Kirkegaard, L, Smitt, M, Buck, DL, Ribergaard, N-E, Pedersen, HS, Christensen, BV & Perner, A 2021, 'Characteristics, interventions and longer-term outcomes of COVID-19 ICU patients in Denmark - a nationwide, observational study', Acta Anaesthesiologica Scandinavica, vol. 65, no. 1, pp. 68-75. https://doi.org/10.1111/aas.13701

TY - JOUR

T1 - Characteristics, interventions and longer-term outcomes of COVID-19 ICU patients in Denmark - a nationwide, observational study

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

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 - Mannering, Anne

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 - Perner, Anders

PY - 2021/1

Y1 - 2021/1

N2 - BACKGROUND: Most data on intensive care unit (ICU) patients with COVID-19 originate in selected populations from stressed healthcare systems with shorter term follow-up. We present characteristics, interventions and longer term outcomes of the entire, unselected cohort of all ICU patients with COVID-19 in Denmark where the ICU capacity was not exceeded.METHODS: We identified all patients with SARS-CoV-2 admitted to any Danish ICU from 10 March to 19 May 2020 and registered demographics, chronic comorbidities, use of organ support, length of stay, and vital status from patient files. Risk factors for death were analyzed using adjusted Cox regression analysis.RESULTS: There were 323 ICU patients with confirmed COVID-19. Median age was 68 years, 74% were men, 50% had hypertension, 21% diabetes, and 20% chronic pulmonary disease; 29% had no chronic comorbidity. Invasive mechanical ventilation was used in 82%, vasopressors in 83%, renal replacement therapy in 26%, and extra corporeal membrane oxygenation in 8%. ICU stay was median 13 days (IQR 6-22) and hospital stay 19 days (11-30). Median follow-up was 79 days. At end of follow-up, 118 had died (37%), 15 (4%) were still in hospital hereof 4 in ICU as of 16 June 2020. Risk factors for mortality included male gender, age, chronic pulmonary disease, active cancer, and number of co-morbidities.CONCLUSIONS: In this nationwide, population-based cohort of ICU patients with COVID-19, longer term survival was high despite high age and substantial use of organ support. Male gender, age, and chronic co-morbidities, in particular chronic pulmonary disease, were associated with increased risk of death.

AB - BACKGROUND: Most data on intensive care unit (ICU) patients with COVID-19 originate in selected populations from stressed healthcare systems with shorter term follow-up. We present characteristics, interventions and longer term outcomes of the entire, unselected cohort of all ICU patients with COVID-19 in Denmark where the ICU capacity was not exceeded.METHODS: We identified all patients with SARS-CoV-2 admitted to any Danish ICU from 10 March to 19 May 2020 and registered demographics, chronic comorbidities, use of organ support, length of stay, and vital status from patient files. Risk factors for death were analyzed using adjusted Cox regression analysis.RESULTS: There were 323 ICU patients with confirmed COVID-19. Median age was 68 years, 74% were men, 50% had hypertension, 21% diabetes, and 20% chronic pulmonary disease; 29% had no chronic comorbidity. Invasive mechanical ventilation was used in 82%, vasopressors in 83%, renal replacement therapy in 26%, and extra corporeal membrane oxygenation in 8%. ICU stay was median 13 days (IQR 6-22) and hospital stay 19 days (11-30). Median follow-up was 79 days. At end of follow-up, 118 had died (37%), 15 (4%) were still in hospital hereof 4 in ICU as of 16 June 2020. Risk factors for mortality included male gender, age, chronic pulmonary disease, active cancer, and number of co-morbidities.CONCLUSIONS: In this nationwide, population-based cohort of ICU patients with COVID-19, longer term survival was high despite high age and substantial use of organ support. Male gender, age, and chronic co-morbidities, in particular chronic pulmonary disease, were associated with increased risk of death.

KW - COVID-19

KW - SARS-CoV-2

KW - comorbidities

KW - intensive care

KW - mortality

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U2 - 10.1111/aas.13701

DO - 10.1111/aas.13701

M3 - Journal article

C2 - 32929715

SN - 0001-5172

VL - 65

SP - 68

EP - 75

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

IS - 1

ER -

Characteristics, interventions and longer-term outcomes of COVID-19 ICU patients in Denmark - a nationwide, observational study

Abstract

Bibliographical note

Keywords

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