Comparison of patients admitted to an inner-city intensive care unit across 3 COVID-19 waves

Venkatram, Sindhaghatta; Dileep, Arundhati; Fortuzi, Ked; Allena, Nishant; Diaz‐Fuentes, Gilda

doi:10.1097/md.0000000000033069

Cited by 3 publications

(1 citation statement)

References 35 publications

(44 reference statements)

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“…A number of smaller studies confirmed the invariably high mortality across the subsequent waves [ 2 , 25 ]. A number of studies found favorable time trends to lower mortality rate among COVID-19 patients admitted at the ICU, but the data were restricted to the first wave [ 1 , 3 – 5 , 26 , 27 ] or the differences in mortality between the waves were not adjusted for important patient characteristics [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

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

Termorshuizen,

Dongelmans,

Brinkman

et al. 2024

Ann. Intensive Care

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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 (ORadj = 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.

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Section: Discussionmentioning

confidence: 99%

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

Termorshuizen,

Dongelmans,

Brinkman

et al. 2024

Ann. Intensive Care

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CT imaging and lung segmentation analysis of SARS-CoV-2 variants and vaccination impacts on lung impairment quantification

Silva,

Alvarez,

Fortaleza

et al. 2024

Multimed Tools Appl

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The role of imaging in detecting and monitoring COVID-19 complications in the Intensive Care Unit (ICU) setting

Brandi,

Renzulli

2024

APS

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Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Most people infected with the virus experience mild to moderate respiratory illness. However, some might become seriously ill and may develop acute respiratory distress syndrome (ARDS), thus requiring non-invasive or invasive mechanical ventilation. Furthermore, COVID-19 disease can involve also other organs and systems, causing several extra-pulmonary manifestations and, thus, negatively influencing the patient’s outcome. Imaging studies play a pivotal role in the monitoring of severely ill patients, especially those admitted to the intensive care unit (ICU), who can develop several potentially life-threatening complications, both from the infection itself and the mechanical supporting system. This widespread utility of imaging modalities calls for a deeper understanding of potential radiologic findings in this disease and the need for multidisciplinary collaboration between radiologists and anesthesiologists to provide actionable guidance to appropriate interventions under such conditions.

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Comparison of patients admitted to an inner-city intensive care unit across 3 COVID-19 waves

Cited by 3 publications

References 35 publications

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

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

CT imaging and lung segmentation analysis of SARS-CoV-2 variants and vaccination impacts on lung impairment quantification

The role of imaging in detecting and monitoring COVID-19 complications in the Intensive Care Unit (ICU) setting

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