Characteristics and outcome of COVID-19 patients admitted to the ICU: a nationwide cohort study on the comparison between the first and the consecutive upsurges of the second wave of the COVID-19 pandemic in the Netherlands
Dutch COVID-19 Research Consortium
(2022) Annals of Intensive Care, volume 12, issue 1
(Article)
Abstract
BACKGROUND: To assess trends in the quality of care for COVID-19 patients at the ICU over the course of time in the Netherlands. 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 indicators of
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quality of care during the first two upsurges (N = 4215: October 5, 2020-January 31, 2021) and the final upsurge of the second wave, called the 'third wave' (N = 4602: February 1, 2021-June 30, 2021) were compared with those during the first wave (N = 2733, February-May 24, 2020). RESULTS: During the second and third wave, there were less patients treated with mechanical ventilation (58.1 and 58.2%) and vasoactive drugs (48.0 and 44.7%) compared to the first wave (79.1% and 67.2%, respectively). The occupancy rates as fraction of occupancy in 2019 (1.68 and 1.55 vs. 1.83), the numbers of ICU relocations (23.8 and 27.6 vs. 32.3%) and the mean length of stay at the ICU (HRs of ICU discharge = 1.26 and 1.42) were lower during the second and third wave. No difference in adjusted hospital mortality between the second wave and the first wave was found, whereas the mortality during the third wave was considerably lower (OR = 0.80, 95% CI [0.71-0.90]). CONCLUSIONS: These data show favorable shifts in the treatment of COVID-19 patients at the ICU over time. The adjusted mortality decreased in the third wave. The high ICU occupancy rate early in the pandemic does probably not explain the high mortality associated with COVID-19.
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Keywords: Coronavirus, COVID-19, Critical Care, Intensive Care, Mortality, Outcome, Critical Care and Intensive Care Medicine, Journal Article
ISSN: 2110-5820
Publisher: Springer-Verlag GmbH and Co. KG
Note: Funding Information: This research was funded by The Netherlands Organisation for Health Research and Development (ZonMw) COVID-19 Programme in the bottom-up focus area 1 “Predictive diagnostics and treatment” for theme 3 “Risk analysis and prognostics” (Project Number 10430 01 201 0011: IRIS). The funder had no role in the design of the study or in the writing of the manuscript. Funding Information: We would like to acknowledge the effort of all Dutch hospitals to record their COVID-19 patients three times a day and additionally all the ICUs that also collected the comprehensive clinical data of the COVID-19 patients to NICE-DB. Without their effort this study would not have been possible. We also like to thank all employees of NICE Research & Support for the technical development of the COVID-19 Online Module, processing the data, and support under high work pressure. Collaborators of the Dutch COVID-19 Research Consortium: Dirk P. Verbiest, Leo F. te Velde, Erik M. van Driel, Tom Rijpstra, Paul W.G. Elbers, Lyuba Georgieva, Eva Verweij, Remko M. de Jong, Freya M. van Iersel, Dick T.J.J. Koning, Els Rengers, Nuray Kusadasi, Michiel L. Erkamp, Roy van den Berg, Creti?n J.M.G. Jacobs, Jelle L. Epker, Annemiek A. Rijkeboer, Martha T. de Bruin, Peter Spronk, Annelies Draisma, Dirk Jan Versluis, Lettie A.E. van den Berg, Marissa Vrolijk-de Mos, Judith A. Lens, D. Jannet Mehagnoul-Schipper, Diederik Gommers, Johan G. Lutisan, Martijn Hoeksema, Ralph V. Pruijsten, Hans Kieft, Jan Rozendaal, Fleur Nooteboom, Dirk P. Boer, Inge T.A. Janssen, Laura van Gulik, M. Peter Koetsier, Vera M. Silderhuis, Ronny M. Schnabel, Ioana Drogt, Wouter de Ruijter, Rob J. Bosman, Tim Frenzel, Louise C. Urlings-Strop, Allard Dijkhuizen, Ilanit Z. Hen?, Arthur R. de Meijer, Jessica W.M. Holtkamp, Nynke Postma, Alexander J.G.H. Bindels, Ronald M.J. Wesselink, Eline R. van Slobbe-Bijlsma, Peter H.J. van der Voort, Bob J.W. Eikemans, Michel G.W. Barnas, Barbara Festen-Spanjer, Maarten van Lieshout, Niels C. Gritters, Martijn van Tellingen, Gert B. Brunnekreef, Joyce Vandeputte, Tom P.J. Dormans, arga E. Hoogendoorn, Mart de Graaff, David Moolenaar, Auke C. Reidinga, Jan Jaap Spijkstra, Ruud de Waal Dirk P. Verbiest, Leo F. te Velde, Erik M. van Driel, Tom Rijpstra, Paul W.G. Elbers, Lyuba Georgieva, Eva Verweij, Remko M. de Jong, Freya M. van Iersel, Dick T.J.J. Koning, Els Rengers, Nuray Kusadasi, Michiel L. Erkamp, Roy van den Berg, Creti?n J.M.G. Jacobs, Jelle L. Epker, Annemiek A. Rijkeboer, Martha T. de Bruin, Peter Spronk, Annelies Draisma, Dirk Jan Versluis, Lettie A.E. van den Berg, Marissa Vrolijk-de Mos, Judith A. Lens, D. Jannet Mehagnoul-Schipper, Diederik Gommers, Johan G. Lutisan, Martijn Hoeksema, Ralph V. Pruijsten, Hans Kieft, Jan Rozendaal, Fleur Nooteboom, Dirk P. Boer, Inge T.A. Janssen, Laura van Gulik, M. Peter Koetsier, Vera M. Silderhuis, Ronny M. Schnabel, Ioana Drogt, Wouter de Ruijter, Rob J. Bosman, Tim Frenzel, Louise C. Urlings-Strop, Allard Dijkhuizen, Ilanit Z. Hen?, Arthur R. de Meijer, Jessica W.M. Holtkamp, Nynke Postma, Alexander J.G.H. Bindels, Ronald M.J. Wesselink, Eline R. van Slobbe-Bijlsma, Peter H. J. van der Voort, Bob J.W. Eikemans, Michel G.W. Barnas, Barbara Festen-Spanjer, Maarten van Lieshout, Niels C. Gritters, Martijn van Tellingen, Gert B. Brunnekreef, Joyce Vandeputte, Tom P.J. Dormans, Marga E. Hoogendoorn, Mart de Graaff, David Moolenaar, Auke C. Reidinga, Jan Jaap Spijkstra, Ruud de Waal. Publisher Copyright: © 2022, The Author(s).
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