Michelle S Chew1, Patrik Johansson Blixt, Rasmus Åhman, Lars Engerström, Henrik Andersson, Ritva Kiiski Berggren, Anders Tegnell, Sarah McIntyre. 1. From the Departments of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences (MSC, PJB, RÅ, HA), Department of Anaesthesia and Intensive Care, Vrinnevi Hospital, Norrköping, Department of Thoracic and Vascular Surgery, Medical and Health Sciences, Linköping University (LE), Department of Anaesthesia, Intensive Care and Perioperative Services, Umeå University Hospital, Umeå (RKB), Department of Public Health Reporting, Public Health Agency of Sweden (AT), Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience, Linköping University, Sweden (SM).
Abstract
BACKGROUND: Mortality among patients admitted to intensive care units (ICUs) with COVID-19 is unclear due to variable follow-up periods. Few nationwide data are available to compare risk factors, treatment and outcomes of COVID-19 patients after ICU admission. OBJECTIVE: To evaluate baseline characteristics, treatments and 30-day outcomes of patients admitted to Swedish ICUs with COVID-19. DESIGN: Registry-based cohort study with prospective data collection. SETTING: Admissions to Swedish ICUs from 6 March to 6 May 2020 with laboratory confirmed COVID-19 disease. PARTICIPANTS: Adult patients admitted to Swedish ICUs. EXPOSURES: Baseline characteristics, intensive care treatments and organ failures. MAIN OUTCOMES AND MEASURES: The primary outcome was 30-day all-cause mortality. A multivariable model was used to determine the independent association between potential predictor variables and death. RESULTS: We identified 1563 patients with complete 30-day follow-up. The 30-day all-cause mortality was 26.7%. Median age was 61 [52 to 69], Simplified Acute Physiology Score III (SAPS III) was 53 [46 to 59] and 62.5% had at least one comorbidity. Median PaO2/FiO2 on admission was 97.5 [75.0 to 140.6] mmHg, 74.7% suffered from moderate-to-severe acute respiratory failure. Age, male sex [adjusted odds ratio (aOR) 1.5 (1.1 to 2.2)], SAPS III score [aOR 1.3 (1.2 to 1.4)], severe respiratory failure [aOR 3.0 (2.0 to 4.7)], specific COVID-19 pharmacotherapy [aOR 1.4 (1.0 to 1.9)] and continuous renal replacement therapy [aOR 2.1 (1.5 to 3.0)] were associated with increased mortality. Except for chronic lung disease, the presence of comorbidities was not independently associated with mortality. CONCLUSIONS: Thirty-day mortality rate in COVID-19 patients admitted to Swedish ICUs is generally lower than previously reported despite a severe degree of hypoxaemia on admission. Mortality was driven by age, baseline disease severity, the presence and degree of organ failure, rather than pre-existing comorbidities. TRIAL REGISTRATION NO: NCT04462393.
BACKGROUND:Mortality among patients admitted to intensive care units (ICUs) with COVID-19 is unclear due to variable follow-up periods. Few nationwide data are available to compare risk factors, treatment and outcomes of COVID-19patients after ICU admission. OBJECTIVE: To evaluate baseline characteristics, treatments and 30-day outcomes of patients admitted to Swedish ICUs with COVID-19. DESIGN: Registry-based cohort study with prospective data collection. SETTING: Admissions to Swedish ICUs from 6 March to 6 May 2020 with laboratory confirmed COVID-19 disease. PARTICIPANTS: Adult patients admitted to Swedish ICUs. EXPOSURES: Baseline characteristics, intensive care treatments and organ failures. MAIN OUTCOMES AND MEASURES: The primary outcome was 30-day all-cause mortality. A multivariable model was used to determine the independent association between potential predictor variables and death. RESULTS: We identified 1563 patients with complete 30-day follow-up. The 30-day all-cause mortality was 26.7%. Median age was 61 [52 to 69], Simplified Acute Physiology Score III (SAPS III) was 53 [46 to 59] and 62.5% had at least one comorbidity. Median PaO2/FiO2 on admission was 97.5 [75.0 to 140.6] mmHg, 74.7% suffered from moderate-to-severe acute respiratory failure. Age, male sex [adjusted odds ratio (aOR) 1.5 (1.1 to 2.2)], SAPS III score [aOR 1.3 (1.2 to 1.4)], severe respiratory failure [aOR 3.0 (2.0 to 4.7)], specific COVID-19 pharmacotherapy [aOR 1.4 (1.0 to 1.9)] and continuous renal replacement therapy [aOR 2.1 (1.5 to 3.0)] were associated with increased mortality. Except for chronic lung disease, the presence of comorbidities was not independently associated with mortality. CONCLUSIONS: Thirty-day mortality rate in COVID-19patients admitted to Swedish ICUs is generally lower than previously reported despite a severe degree of hypoxaemia on admission. Mortality was driven by age, baseline disease severity, the presence and degree of organ failure, rather than pre-existing comorbidities. TRIAL REGISTRATION NO: NCT04462393.
Authors: Michelle S Chew; Salla Kattainen; Nicolai Haase; Eirik A Buanes; Linda B Kristinsdottir; Kristin Hofsø; Jon Henrik Laake; Reidar Kvåle; Johanna Hästbacka; Matti Reinikainen; Stepani Bendel; Tero Varpula; Sten Walther; Anders Perner; Hans K Flaatten; Martin I Sigurdsson Journal: Acta Anaesthesiol Scand Date: 2021-10-03 Impact factor: 2.274
Authors: 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 Journal: Acta Anaesthesiol Scand Date: 2022-08-02 Impact factor: 2.274