High severity and mortality of non-COVID-19 critically ill patients during the COVID-19 pandemic

Abstract

<b>Background:</b> The transmission and the fatality rates of coronavirus disease 2019 (COVID-19) are high enough to cause the strain of intensive care resources, and even influence the treatment and prognosis of non-COVID-19 patients. Therefore, the collateral damages to non-COVID-19 critically ill patients before and during the COVID-19 pandemic were evaluated. <b>Methods:</b> Demographic data, severity, clinical course, and prognosis of non-COVID-19 patients admitted to the intensive care unit (ICU) via the emergency room (ER) before and during the COVID-19 pandemic were acquired from electronic medical records from three university-affiliated tertiary hospitals. <b>Results:</b> A total of 619 patients before and 542 patients during the pandemic were enrolled. During the COVID-19 pandemic, simplified acute physiology score (SAPS) 3 and the sequential organ failure assessment score (SOFA) on ER admission (SAPS3 72.7 ± 20.3 versus 65.9 ± 18.6, p &lt;0.001, respectively; SOFA score 8.1 ± 4.2, versus 7.2 ±4.2, p &lt;0.001, respectively) were significantly higher than those before the pandemic. The length of stay in the ER, ICU, and hospital was longer (p&lt;0.05 in all). Finally, the hospital mortality rate was significantly higher during the pandemic than those before (39.7% versus 28.4%, p&lt;0.001). The overall survival in the Kaplan-Meier curve analysis with log-rank test was significantly higher during the pandemic (p=0.04). <b>Conclusion:</b> These result of increased severity, hospital day and mortality in non-COVID-19 patients indicate the collateral damage to non-COVID-19 patients due to shortages in medical resources for them. Strategic management of medical resources is required to halt these consequences.