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A descriptive study of the surge response and outcomes of ICU patients with COVID-19 during first wave in Nordic countries

A descriptive study of the surge response and outcomes of ICU patients with COVID-19 during first wave in Nordic countries


Title: A descriptive study of the surge response and outcomes of ICU patients with COVID-19 during first wave in Nordic countries
Author: Chew, Michelle S.
Kattainen, Salla
Haase, Nicolai
Buanes, Eirik A.
Kristinsdóttir, Linda B.
Hofsø, Kristin
Laake, Jon Henrik
Kvåle, Reidar
Hästbacka, Johanna
Reinikainen, Matti
... 6 more authors Show all authors
Date: 2022-01
Language: English
Scope: 9
University/Institute: Landspitali - The National University Hospital of Iceland
Department: Perioperative Services
Faculty of Medicine
Series: Acta Anaesthesiologica Scandinavica; 66(1)
ISSN: 0001-5172
DOI: https://doi.org/10.1111/aas.13983
Subject: COVID-19; Dánartíðni; Norðurlönd; Norðurlönd; COVID-19; mortality; Nordic; SARS-CoV2; Intensive Care Units; SARS-CoV-2; Pandemics; Humans; Adult; Critical Care; Aged; Anesthesiology and Pain Medicine
URI: https://hdl.handle.net/20.500.11815/2858

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Citation:

Chew , M S , Kattainen , S , Haase , N , Buanes , E A , Kristinsdóttir , L B , Hofsø , K , Laake , J H , Kvåle , R , Hästbacka , J , Reinikainen , M , Bendel , S , Varpula , T , Walther , S , Perner , A , Flaatten , H K & Sigurðsson , M I 2022 , ' A descriptive study of the surge response and outcomes of ICU patients with COVID-19 during first wave in Nordic countries ' , Acta Anaesthesiologica Scandinavica , vol. 66 , no. 1 , pp. 56-64 . https://doi.org/10.1111/aas.13983

Abstract:

Background: We sought to provide a description of surge response strategies and characteristics, clinical management and outcomes of patients with severe COVID-19 in the intensive care unit (ICU) during the first wave of the pandemic in Denmark, Finland, Iceland, Norway and Sweden. Methods: Representatives from the national ICU registries for each of the five countries provided clinical data and a description of the strategies to allocate ICU resources and increase the ICU capacity during the pandemic. All adult patients admitted to the ICU for COVID-19 disease during the first wave of COVID-19 were included. The clinical characteristics, ICU management and outcomes of individual countries were described with descriptive statistics. Results: Most countries more than doubled their ICU capacity during the pandemic. For patients positive for SARS-CoV-2, the ratio of requiring ICU admission for COVID-19 varied substantially (1.6%–6.7%). Apart from age (proportion of patients aged 65 years or over between 29% and 62%), baseline characteristics, chronic comorbidity burden and acute presentations of COVID-19 disease were similar among the five countries. While utilization of invasive mechanical ventilation was high (59%–85%) in all countries, the proportion of patients receiving renal replacement therapy (7%–26%) and various experimental therapies for COVID-19 disease varied substantially (e.g. use of hydroxychloroquine 0%–85%). Crude ICU mortality ranged from 11% to 33%. Conclusion: There was substantial variability in the critical care response in Nordic ICUs to the first wave of COVID-19 pandemic, including usage of experimental medications. While ICU mortality was low in all countries, the observed variability warrants further attention.

Description:

Funding: NordForsk (Nordic COVID-19 Activities), Finnish Society of Intensive Care. Publisher Copyright: © 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd

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