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

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.

• 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 anaesthesiologica Scandinavica (Acta Anaesthesiol Scand) Vol. 66 Issue 1 Pg. 56-64 (01 2022) ISSN: 1399-6576 [Electronic] England
• PMID: 34570897 (Publication Type: Journal Article)
• Copyright: © 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Topics

• Adult
• Aged
• COVID-19
• Critical Care
• Humans
• Intensive Care Units
• Pandemics
• SARS-CoV-2