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COVID-19 critical illness in Sweden: characteristics and outcomes at a national population level
Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
Linköping University, Department of Health, Medicine and Caring Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Thoracic and Vascular Surgery. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping. Swedish Intens Care Registry, Karlstad, Sweden.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Thoracic and Vascular Surgery. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping. Swedish Intens Care Registry, Sweden.ORCID iD: 0000-0002-3862-2556
Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
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2020 (English)In: Critical Care and Resuscitation, ISSN 1441-2772, Vol. 22, no 4, p. 312-320Article in journal (Refereed) Published
Abstract [en]

Objective: During the coronavirus disease 2019 (COVID-19) pandemic, baseline demographics and comorbidities of patients with COVID-19 have been presented, but there are limited data on outcomes of severely ill patients. We aimed to examine the association between patient characteristics and 30-day mortality among patients with COVID-19 treated in the intensive care unit (ICU). Design: Population-based cohort study. Setting: ICUs in Sweden. Participants: All consecutive patients with COVID-19 admitted to Swedish ICUs from 6 March to 5 April 2020. Main outcome measures: The primary outcome was 30-day mortality after ICU admission. Patient demographics, comorbidities and clinical characteristics were also retrieved. Results: A total of 604 patients were included. The median age was 61 years (interquartile range [IQR], 52-70 years) and 458 patients (76%) were males. The most common comorbidities were hypertension (35.9%) and diabetes (25.7%), whereas 36.4% of patients had no comorbidities. Median Simplified Acute Physiology Score (SAPS) 3 was 53 (IQR, 46-60). Of 573 patients with available respiratory support data, 487 (85.0%) received invasive mechanical ventilation. Among 518 patients with available data, 117 (22.6%) received renal replacement therapy. Median length of stay was 13 days (IQR, 6-20 days). Mortality at 30 days was 32.6%. In the multivariable Cox regression model, age (hazard ratio [HR] 1.06; 95% CI, 1.04-1.07 per year), the presence of one or more comorbidities (HR, 1.80; 95% CI, 1.20-2.68), chronic obstructive pulmonary disease or asthma (HR, 1.68; 95% CI, 1.12-2.50), hypertension (HR, 1.41; 95% CI, 1.01-1.99), and acute illness severity (SAPS 3 excluding age and comorbidity) (HR, 1.06; 95% CI, 1.04-1.09) were associated with 30-day mortality. Conclusions: This population-based cohort study presents 30-day mortality of 604 ICU patients with COVID-19. The higher mortality was explained by older age, the presence chronic illness, and acute illness severity.

Place, publisher, year, edition, pages
Strawberry Hills, NSW, Australia: AUSTRALASIAN MED PUBL CO LTD , 2020. Vol. 22, no 4, p. 312-320
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:liu:diva-173511ISI: 000612535900005OAI: oai:DiVA.org:liu-173511DiVA, id: diva2:1530319
Note

Funding Agencies|Knut and Alice Wallenberg FoundationKnut & Alice Wallenberg Foundation

Available from: 2021-02-22 Created: 2021-02-22 Last updated: 2021-10-04Bibliographically approved

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Walther, Sten M.

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Engerström, LarsWalther, Sten M.Larsson, Emma
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Department of Health, Medicine and Caring SciencesFaculty of Medicine and Health SciencesDepartment of Thoracic and Vascular SurgeryDepartment of Anaesthesiology and Intensive Care in NorrköpingDivision of Diagnostics and Specialist Medicine
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Critical Care and Resuscitation
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