Comparing Critical Care Admissions Among Urban Populations Before and During the COVID-19 Pandemic

Background After the COVID-19 pandemic started, critical care resources were expanded in Finland to manage a possible surge in patients requiring intensive care. The aim of this study was to evaluate the incidence of overall ICU admissions, patient diagnoses, characteristics, and length of stay during the pandemic. Methods This retrospective hospital register-based study was conducted in two large and one mid-size Finnish public hospitals. The required data were collected from ICU patient information systems and all adult patients were included. Monthly and yearly incidences with 95% confidence intervals (CI) were counted per 100 000 persons-years by Poisson exact method and compared by incidence rate ratios (IRR). Results A total of 4407 admissions to ICUs for any cause occurred during 2020. In 2021, this figure was 4931. During the reference years (2017–2019), the mean number of admissions to ICU was 4781. In 2020 and 2021, the proportion of patients requiring intensive care due to COVID-19 was only 3%. The incidence of all-cause ICU admissions decreased during the lockdown in 2020 when compared to the reference years. Before the start of the lockdown in February 2020, the IRR of all-cause ICU admissions was 1.02 (CI: 0.89 to 1.18). During the lockdown period, however, the IRR of all-cause ICU admissions decreased to 0.78 (CI: 0.67 to 0.90) in March. When the lockdown ended, the incidence rebounded to the same level as before the lockdown. However, in 2021, the incidence of ICU admissions remained at the same level when compared to the reference years. The most prominent changes occurred in the incidence of diseases of the nervous system, which includes epilepsy and seizures and transient cerebral ischemic attacks, in diseases of the respiratory system, and neoplasms. Conclusions According to the findings of this study, the incidence of all-cause ICU admissions decreased after the lockdown was implemented in 2020. Furthermore, the percentage of patients requiring intensive care due to COVID-19 in Finland was only 3% in 2020 and 2021. These findings may serve to help in the planning and allocating of ICU resources during future pandemics.

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“…Previous literature has yielded conflicting results, as both increases and decreases in non-COVID-19 ICU admissions have been reported [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Intensive care unit admissions with and without COVID-19 in Finland from 2017 to 2021: a retrospective register-based study

et al. 2023

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“…Furthermore, the COVID-19 burden is unevenly distributed: marginalized populations such as non-Italians and refugees have been impaired by a higher COVID-19 incidence and mortality rate [7]. In western countries, ethnic disparities played a dramatic role during the pandemic: ethnic minorities faced an excess of risks of testing positive for SARS-CoV-2, hospitalization, and adverse COVID-19 health outcomes compared with the White population [8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Socio-Economic Factors Associated with Ethnic Disparities in SARS-CoV-2 Infection and Hospitalization

Gili

Caminiti

Lupi

et al. 2023

IJERPH

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Background: There is evidence that non-Italians presented higher incidence of infection and worse health outcomes if compared to native populations in the COVID-19 pandemic. The aim of the study was to compare Italian- and non-Italian-born health outcomes, accounting for socio-economic levels. Methods: We analyzed data relative to 906,463 people in Umbria (Italy) from 21 February 2020 to 31 May 2021. We considered the National Deprivation Index, the Urban–Rural Municipalities Index and the Human Development Index (HDI) of the country of birth. We used a multilevel logistic regression model to explore the influence of these factors on SARS-CoV-2 infection and hospitalization rates. Diagnosis in the 48 h preceding admission was an indicator of late diagnosis among hospitalized cases. Results: Overall, 54,448 persons tested positive (6%), and 9.7% of them were hospitalized. The risk of hospital admission was higher among non-Italians and was inversely related to the HDI of the country of birth. A diagnosis within 48 h before hospitalization was more frequent among non-Italians and correlated to the HDI level. Conclusions: COVID-19 had unequal health outcomes among the population in Umbria. Reduced access to primary care services in the non-Italian group could explain our findings. Policies on immigrants' access to primary healthcare need to be improved.

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Linking Sepsis with chronic arterial hypertension, diabetes mellitus, and socioeconomic factors in the United States: A scoping review

Ahlberg¹,

Wallam²,

Tirba³

et al. 2023

Journal of Critical Care

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Comparing Critical Care Admissions Among Urban Populations Before and During the COVID-19 Pandemic

Cited by 3 publications

References 21 publications

Intensive care unit admissions with and without COVID-19 in Finland from 2017 to 2021: a retrospective register-based study

Intensive care unit admissions with and without COVID-19 in Finland from 2017 to 2021: a retrospective register-based study

Socio-Economic Factors Associated with Ethnic Disparities in SARS-CoV-2 Infection and Hospitalization

Linking Sepsis with chronic arterial hypertension, diabetes mellitus, and socioeconomic factors in the United States: A scoping review

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