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Background Most data on intensive care unit (ICU) patients with COVID‐19 originate in selected populations from stressed healthcare systems with shorter term follow‐up. We present characteristics, interventions and longer term outcomes of the entire, unselected cohort of all ICU patients with COVID‐19 in Denmark where the ICU capacity was not exceeded. Methods We identified all patients with SARS‐CoV‐2 admitted to any Danish ICU from 10 March to 19 May 2020 and registered demographics, chronic comorbidities, use of organ support, length of stay, and vital status from patient files. Risk factors for death were analyzed using adjusted Cox regression analysis. Results There were 323 ICU patients with confirmed COVID‐19. Median age was 68 years, 74% were men, 50% had hypertension, 21% diabetes, and 20% chronic pulmonary disease; 29% had no chronic comorbidity. Invasive mechanical ventilation was used in 82%, vasopressors in 83%, renal replacement therapy in 26%, and extra corporeal membrane oxygenation in 8%. ICU stay was median 13 days (IQR 6‐22) and hospital stay 19 days (11‐30). Median follow‐up was 79 days. At end of follow‐up, 118 had died (37%), 15 (4%) were still in hospital hereof 4 in ICU as of 16 June 2020. Risk factors for mortality included male gender, age, chronic pulmonary disease, active cancer, and number of co‐morbidities. Conclusions In this nationwide, population‐based cohort of ICU patients with COVID‐19, longer term survival was high despite high age and substantial use of organ support. Male gender, age, and chronic co‐morbidities, in particular chronic pulmonary disease, were associated with increased risk of death.

Background: Characteristics and care of intensive care unit (ICU) patients with COVID-19 may have changed during the pandemic, but longitudinal data assessing this are limited. We compared patients with COVID-19 admitted to Danish ICUs in the first wave with those admitted later.Methods: Among all Danish ICU patients with COVID-19, we compared demographics, chronic comorbidities, use of organ support, length of stay and vital status of those admitted 10 March to 19 May 2020 (first wave) versus 20 May 2020 to 30 June 2021. We analysed risk factors for death by adjusted logistic regression analysis.Results: Among all hospitalised patients with COVID-19, a lower proportion was admitted to ICU after the first wave (13% vs. 8%). Among all 1374 ICU patients with COVID-19, 326 were admitted during the first wave. There were no major differences in patient's characteristics or mortality between the two periods, but use of invasive mechanical ventilation (81% vs. 58% of patients), renal replacement therapy (26% vs. 13%) and ECMO (8% vs. 3%) and median length of stay in ICU (13 vs. 10 days) and in hospital (20 vs. 17 days) were all significantly lower after the first wave. Risk factors for death were higher age, larger burden of comorbidities (heart failure, pulmonary disease and kidney disease) and active cancer, but not admission during or after the first wave.Conclusions: After the first wave of COVID-19 in Denmark, a lower proportion of hospitalised patients with COVID-19 were admitted to ICU. Among ICU patients, use of organ support was lower and length of stay was reduced, but mortality rates remained at a relatively high level.

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In a double-blind, randomized trial, the efficacy and safety of flumazenil, a benzodiazepine antagonist, was evaluated in patients after gastroscopy under midazolam or diazepam sedation. The criteria of efficacy were the degree of sedation and anterograde amnesia. Flumazenil significantly reduced the degree of sedation in both groups without significant intergroup differences. No sign of resedation was found during the observation period of 3 h. The anterograde amnesia was effectively antagonized in both groups. Flumazenil was well tolerated. Flumazenil is a safe and effective benzodiazepine antagonist which makes it possible to reduce the recovery period in outpatients sedated sufficiently with benzodiazepines for gastroscopy.