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

• Published in: Acta Anaesthesiologica Scandinavica
• Main Authors: Chew, Michelle S, Kattainen, Salla, Haase, Nicolai, Buanes, Eirik A, Kristinsdottir, Linda B, Hofsø, Kristin, Laake, Jon Henrik, Kvåle, Reidar, Hästbacka, Johanna, Reinikainen, Matti, Bendel, Stepani, Varpula, Tero, Walther, Sten, Perner, Anders, Flaatten, Hans K, Sigurdsson, Martin I
• Other Authors: 1Departments of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. 2Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital, Helsinki, Finland. 3Faculty of Medicine, University of Helsinki, Helsinki, Finland. 4Department of Intensive Care, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 5Norwegian Intensive Care and Pandemic Registry, Helse Bergen Health Trust, Bergen, Norway. 6Department of Anaesthesiology and Critical Care, Perioperative Services, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland. 7Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway. 8Lovisenberg Diaconal University College, Oslo, Norway. 9Department of Anaesthesiology and Department of Research and Development, Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway. 10Norwegian Intensive Care Registry, Helse Bergen HF, Bergen, Norway. 11Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway. 12Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. 13Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland. 14Swedish Intensive Care Registry, Värmland County Council, Karlstad, Sweden. 15Department of Cardiothoracic and Vascular Surgery, Linköping University Hospital, Linköping, Sweden. 16Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. 17Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2022
• Subjects: COVID-19; Nordic; SARS-CoV2; mortality; Gjörgæsla; Intensive Care Units; Critical Care; Norway; Iceland
• Online Access: http://hdl.handle.net/2336/622022; https://doi.org/10.1111/aas.13983

To access publisher's full text version of this article click on the hyperlink below 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. Keywords: COVID-19; Nordic; SARS-CoV2; mortality. NordForsk (Nordic COVID-19 Activities) Finnish Society of Intensive Care