In-hospital mortality in patients admitted to Australian intensive care units with COVID-19 between 2020 and 2024

IF 1.4 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation Pub Date : 2025-03-01 DOI:10.1016/j.ccrj.2024.11.003

Matthew T. Donnan MBBS , Peinan Zhao PhD , Allen C. Cheng MBBS PhD , Aaliya Ibrahim MClinEpid , Annamaria Palermo RN, BA , Benjamin Reddi FCICM PhD , Claire Reynolds MNurs , Craig French MBBS , Edward Litton MBChB PhD , Hannah Rotherham MBBS , Husna Begum PhD , Jamie Cooper MD MBBS , Jodi Dumbrell MPH , Lewis Campbell FCICM MSc. , Mark Plummer PhD , Mahesh Ramanan FCICM MMed , Patricia Alliegro MD , Richard E. McAllister RN, BN , Simon Erickson MBBS, CICM , Shweta Priyadarshini FCICM MBBS , Aidan Burrell MBBS PhD

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引用次数: 0

Abstract

Objective

To describe and compare the demographics, management, and outcomes for patients with COVID-19 admitted to intensive care units (ICUs) in Australia across the various waves of the COVID pandemic.

Design, setting, and participants

People aged ≥16 years who were admitted to a participating ICU with confirmed COVID-19 in the Short Period Incidence Study of Severe Acute Respiratory Infection (SPRINT-SARI) Australia study between February 2020 and May 2024.

Main outcome measures

Primary outcome: In-hospital mortality. Secondary outcomes: ICU mortality; ICU and hospital lengths of stay; supportive and disease-specific therapies.

Results

From 27 February 2020 to 18 May 2024, 10171 people were admitted to 72 ICUs with confirmed COVID-19 disease. The Wild Type wave included 518 (5.1%) patients, the Delta wave 2467 (24.3%) patients, and the Omicron wave 7186 (70.7%) patients. The median (IQR) age was 61 (49–70) years, 54 (41–66) years, and 65 (45–75) years, respectively (P < 0.001). The proportion of vaccinated cases increased in successive waves (1% vs 23.9% vs 65.1%) but plateaued in the Omicron subvariant waves (range 60.0%–71.9%). Invasive mechanical ventilation use decreased across successive waves (52.5% vs 43.6% vs 31.7%, P < 0.001). Use of extracorporeal membrane oxygenation was highest during the Delta wave (3.6%, 83 patients, median duration 18 days [IQR 9.8–35]). Multivariable analysis demonstrated an increased risk of in-hospital mortality among patients admitted during the Delta (adjusted HR 1.80, 95% CI: 1.38–2.35, p < 0.001) and Omicron (adjusted HR 1.88, 95% CI: 1.46–2.42, p < 0.001) waves when compared to the Wild Type wave.

Conclusion

COVID-19 continues to manifest significant morbidity and mortality in those requiring ICU admission. Despite a reduced need for ICU level supports, patients admitted during the Omicron wave demonstrated the highest in-hospital mortality.

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来源期刊

Critical Care and Resuscitation CRITICAL CARE MEDICINE-

CiteScore

7.70

自引率

3.40%

发文量

审稿时长

>12 weeks

期刊介绍： ritical Care and Resuscitation (CC&R) is the official scientific journal of the College of Intensive Care Medicine (CICM). The Journal is a quarterly publication (ISSN 1441-2772) with original articles of scientific and clinical interest in the specialities of Critical Care, Intensive Care, Anaesthesia, Emergency Medicine and related disciplines. The Journal is received by all Fellows and trainees, along with an increasing number of subscribers from around the world. The CC&R Journal currently has an impact factor of 3.3, placing it in 8th position in world critical care journals and in first position in the world outside the USA and Europe.