Abstract
BackgroundCoronavirus disease 2019 (COVID-19) disrupts routine care and alters treatment pathways in every medical specialty, including intensive care medicine, which has been at the core of the pandemic response. The impact of the pandemic is inevitably not limited to patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and their outcomes; however, the impact of COVID-19 on intensive care has not yet been analyzed.MethodsThe objective of this propensity score-matched study was to compare the clinical outcomes of non-COVID-19 critically ill patients with the outcomes of prepandemic patients. Critically ill, non-COVID-19 patients admitted to the intensive care unit (ICU) during the first wave of the pandemic were matched with patients admitted in the previous year. Mortality, length of stay, and rate of readmission were compared between the two groups after matching.ResultsA total of 211 critically ill SARS-CoV‑2 negative patients admitted between 13 March 2020 and 16 May 2020 were matched to 211 controls, selected from a matching pool of 1421 eligible patients admitted to the ICU in 2019. After matching, the outcomes were not significantly different between the two groups: ICU mortality was 5.2% in 2019 and 8.5% in 2020, p = 0.248, while intrahospital mortality was 10.9% in 2019 and 14.2% in 2020, p = 0.378. The median ICU length of stay was similar in 2019: 4 days (IQR 2–6) compared to 2020: 4 days (IQR 2–7), p = 0.196. The rate of ICU readmission was 15.6% in 2019 and 10.9% in 2020, p = 0.344.ConclusionIn this retrospective single center study, mortality, ICU length of stay, and rate of ICU readmission did not differ significantly between patients admitted to the ICU during the implementation of hospital-wide COVID-19 contingency planning and patients admitted to the ICU before the pandemic.
Highlights
BackgroundCoronavirus disease (COVID-19), the acute respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains a global health concern almost 1 year after emerging [1]
The rate of intensive care unit (ICU) readmission was 15.6% in 2019 and 10.9% in 2020, p = 0.344. In this retrospective single center study, mortality, ICU length of stay, and rate of ICU readmission did not differ significantly between patients admitted to the ICU during the implementation of hospital-wide COVID-19 contingency planning and patients admitted to the ICU before the pandemic
We performed a vertical comparison between the clinical outcomes of patients admitted to the ICU while the COVID-19-associated measures were in place and the outcomes of critically ill patients from previous year
Summary
BackgroundCoronavirus disease (COVID-19), the acute respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains a global health concern almost 1 year after emerging [1]. The rapid spread of the disease and the high rates of intensive care unit (ICU) admission in hospitalized patients pose major challenges to healthcare systems worldwide [3,4,5]. Healthcare systems have been reorganized to address the high number of patients: elective surgical activity has been reduced or cancelled, access to inpatient facilities has been restricted, visitor numbers have been limited, and provisional facilities designated for managing COVID-19 cases have been created [3, 6,7,8]. The growing body of evidence on COVID-19 has led to a development of numerous management guidelines and new treatment options [9,10,11]; the impact of the pandemic inevitably extends beyond the patients infected with SARS-CoV-2. The reduction of elective activity was accompanied by a decline in hospital admission rates for cardiovascular emergencies and an increase in intrahospital mortality [15,16,17,18]
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