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Characteristics and outcome of COVID-19 patients admitted to the ICU: a nationwide cohort study on the comparison between the consecutive stages of the COVID-19 pandemic in the Netherlands, an update.
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- Author(s): Termorshuizen, Fabian; Dongelmans, Dave A.; Brinkman, Sylvia; Bakhshi-Raiez, Ferishta; Arbous, M. Sesmu; de Lange, Dylan W.; van Bussel, Bas C. T.; de Keizer, Nicolette F.; the Dutch COVID-19 Research Consortium; Barnas, M.G.W.; Boer, D.P.; Bosman, R.J.; Brunnekreef, G.B.; de Graaff, M.; de Jong, R.M.; de Meijer, A.R.; de Ruijter, W.; de Waal, R.; Dijkhuizen, A.; Dormans, T.P.J.
- Source:
Annals of Intensive Care; 1/16/2024, Vol. 14 Issue 1, p1-12, 12p- Subject Terms:
MORTALITY risk factors; INTENSIVE care units; REPORTING of diseases; MEDICAL quality control; LENGTH of stay in hospitals; COVID-19; CONFIDENCE intervals; HOSPITAL utilization; CRITICALLY ill; TIME; MULTIVARIATE analysis; PATIENTS; MEDICAL care costs; HOSPITAL admission & discharge; HOSPITAL mortality; MEDICAL care use; IMMUNITY; RESEARCH funding; MICROBIAL virulence; RELOCATION; ELECTRONIC health records; ODDS ratio; DATA analysis software; LOGISTIC regression analysis; COMORBIDITY; EVALUATION - Source:
- Additional Information
- Subject Terms:
- Abstract: Background: Previously, we reported a decreased mortality rate among patients with COVID-19 who were admitted at the ICU during the final upsurge of the second wave (February–June 2021) in the Netherlands. We examined whether this decrease persisted during the third wave and the phases with decreasing incidence of COVID-19 thereafter and brought up to date the information on patient characteristics. Methods: Data from the National Intensive Care Evaluation (NICE)-registry of all COVID-19 patients admitted to an ICU in the Netherlands were used. Patient characteristics and rates of in-hospital mortality (the primary outcome) during the consecutive periods after the first wave (periods 2–9, May 25, 2020–January 31, 2023) were compared with those during the first wave (period 1, February–May 24, 2020). Results: After adjustment for patient characteristics and ICU occupancy rate, the mortality risk during the initial upsurge of the third wave (period 6, October 5, 2021–January, 31, 2022) was similar to that of the first wave (OR
adj = 1.01, 95%-CI [0.88–1.16]). The mortality rates thereafter decreased again (e.g., period 9, October 5, 2022–January, 31, 2023: ORadj = 0.52, 95%-CI [0.41–0.66]). Among the SARS-CoV-2 positive patients, there was a huge drop in the proportion of patients with COVID-19 as main reason for ICU admission: from 88.2% during the initial upsurge of the third wave to 51.7%, 37.3%, and 41.9% for the periods thereafter. Restricting the analysis to these patients did not modify the results on mortality. Conclusions: The results show variation in mortality rates among critically ill COVID-19 patients across the calendar time periods that is not explained by differences in case-mix and ICU occupancy rates or by varying proportions of patients with COVID-19 as main reason for ICU admission. The consistent increase in mortality during the initial, rising phase of each separate wave might be caused by the increased virulence of the contemporary virus strain and lacking immunity to the new strain, besides unmeasured patient-, treatment- and healthcare system characteristics. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of Annals of Intensive Care is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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