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Chew MS, Kattainen S, Haase N, et al. A descriptive study of the surge response and outcomes of ICU patients with COVID-19 during first wave in Nordic countries. Acta Anaesthesiol Scand. 2021;66(1):56-64doi: 10.1111/aas.13983.
Chew, M. S., Kattainen, S., Haase, N., Buanes, E. A., Kristinsdottir, L. B., Hofsø, K., Laake, J. H., Kvåle, R., Hästbacka, J., Reinikainen, M., Bendel, S., Varpula, T., Walther, S., Perner, A., Flaatten, H. K., & Sigurdsson, M. I. (2022). A descriptive study of the surge response and outcomes of ICU patients with COVID-19 during first wave in Nordic countries. Acta anaesthesiologica Scandinavica, 66(1), 56-64. https://doi.org/10.1111/aas.13983
Chew, Michelle S, et al. "A descriptive study of the surge response and outcomes of ICU patients with COVID-19 during first wave in Nordic countries." Acta anaesthesiologica Scandinavica vol. 66,1 (2022): 56-64. doi: https://doi.org/10.1111/aas.13983
Chew MS, Kattainen S, Haase N, Buanes EA, Kristinsdottir LB, Hofsø K, Laake JH, Kvåle R, Hästbacka J, Reinikainen M, Bendel S, Varpula T, Walther S, Perner A, Flaatten HK, Sigurdsson MI. A descriptive study of the surge response and outcomes of ICU patients with COVID-19 during first wave in Nordic countries. Acta Anaesthesiol Scand. 2022 Jan;66(1):56-64. doi: 10.1111/aas.13983. Epub 2021 Oct 03. PMID: 34570897; PMCID: PMC8652908.
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Acta Anaesthesiol Scand. 2022 Jan;66(1):56-64. doi: 10.1111/aas.13983. Epub 2021 Oct 03.

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

Acta anaesthesiologica Scandinavica

Michelle S Chew, Salla Kattainen, Nicolai Haase, Eirik A Buanes, Linda B Kristinsdottir, Kristin Hofsø, Jon Henrik Laake, Reidar Kvåle, Johanna Hästbacka, Matti Reinikainen, Stepani Bendel, Tero Varpula, Sten Walther, Anders Perner, Hans K Flaatten, Martin I Sigurdsson

Affiliations

  1. Departments of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
  2. Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital, Helsinki, Finland.
  3. Faculty of Medicine, University of Helsinki, Helsinki, Finland.
  4. Department of Intensive Care, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  5. Norwegian Intensive Care and Pandemic Registry, Helse Bergen Health Trust, Bergen, Norway.
  6. Department of Anaesthesiology and Critical Care, Perioperative Services, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
  7. Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
  8. Lovisenberg Diaconal University College, Oslo, Norway.
  9. Department of Anaesthesiology and Department of Research and Development, Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway.
  10. Norwegian Intensive Care Registry, Helse Bergen HF, Bergen, Norway.
  11. Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
  12. Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
  13. Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland.
  14. Swedish Intensive Care Registry, Värmland County Council, Karlstad, Sweden.
  15. Department of Cardiothoracic and Vascular Surgery, Linköping University Hospital, Linköping, Sweden.
  16. Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
  17. Faculty of Medicine, University of Iceland, Reykjavik, Iceland.

PMID: 34570897 PMCID: PMC8652908 DOI: 10.1111/aas.13983

Abstract

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.

© 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Keywords: COVID-19; Nordic; SARS-CoV2; mortality

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