Donnan, Matthew T

Zhao, Peinan

Cheng, Allen C

Ibrahim, Aaliya

Palermo, Annamaria

Reddi, Benjamin

Reynolds, Claire

French, Craig

Litton, Edward

Rotherham, Hannah

Begum, Husna

Cooper, Jamie

Dumbrell, Jodi

Campbell, Lewis

Plummer, Mark

Ramanan, Mahesh

Alliegro, Patricia

McAllister, Richard E

Erickson, Simon

Priyadarshini, Shweta

Ng, Sze

Broadley, Tessa

Trapani, Tony

Papanikolaou, Vicki

Cheung, Winston

Udy, Andrew A

Burrell, Aidan

2025-02-28

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.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.Primary outcome: In-hospital mortality. Secondary outcomes: ICU mortality; ICU and hospital lengths of stay; supportive and disease-specific therapies.From 27 February 2020 to 18 May 2024, 10171 people were admitted to 72 ICUs with confirmed COVID-19 disease. The ave included 518 (5.1%) patients, the wave 2467 (24.3%) patients, and the 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 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 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 D (adjusted HR 1.80, 95% CI: 1.38-2.35,  < 0.001) and (adjusted HR 1.88, 95% CI: 1.46-2.42,  < 0.001) waves when compared to the wave.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 wave demonstrated the highest in-hospital mortality.

Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Australia.

Department of Respiratory Medicine, The Alfred Hospital, Melbourne, Australia.

School of Translational Medicine, Monash University, The Alfred Hospital, Melbourne, Australia.

School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Monash Infectious Diseases, Monash Health and School of Clinical Sciences, Monash University, Clayton, VIC, Australia.

Health Protection Policy and Surveillance Division, Interim Australian Centre for Disease Control (CDC), Australia Government Department of Health and Aged Care, Australia.

Intensive Care Unit, Fiona Stanley Hospital, Perth, WA, Australia.

Royal Adelaide Hospital, Adelaide, SA, Australia.

University of Adelaide, Adelaide, SA, Australia.

Intensive Care Unit, St Vincent's Health Network, Sydney, NSW, Australia.

The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resources Evaluation, Melbourne, VIC, Australia.

Department of Intensive Care, Western Health, Melbourne, VIC, Australia.

Intensive Care Unit, Fiona Stanley Hospital, Perth, WA, Australia.

Department of Intensive Care Medicine, St John of God Hospital Subiaco, Perth, WA, Australia.

Intensive Care Unit, Royal Melbourne Hospital, Parkville, VIC, Australia.

Department of Critical Care, The University of Melbourne, Parkville, VIC, Australia.

Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.

Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Australia.

Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.

Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.

Intensive Care Unit, Royal Darwin Hospital, Darwin, NT, Australia.

Menzies School of Health Research, Darwin, NT, Australia.

Intensive Care Unit, Royal Melbourne Hospital, Parkville, VIC, Australia.

Intensive Care Unit, Caboolture Hospital, Caboolture, QLD, Australia.

Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.

Department of Critical Care Medicine, Royal Hobart Hospital, Hobart, TAS, Australia.

Perth Children's Hospital, Perth, WA, Australia.

Department of Intensive Care Medicine, St Vincent's Healthcare Clinical Campus, Sydney, Australia.

Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.

Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.

Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.

Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.

Department of Intensive Care Medicine, Concord Repatriation General Hospital, Sydney, NSW, Australia.

Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Australia.

School of Translational Medicine, Monash University, The Alfred Hospital, Melbourne, Australia.

Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.

Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Australia.

School of Translational Medicine, Monash University, The Alfred Hospital, Melbourne, Australia.

Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.

Crit Care Resusc . 2025 Feb 28;27(1):100094. doi: 10.1016/j.ccrj.2024.11.003. eCollection 2025 Mar.

1441-2772

https://pubmed.ncbi.nlm.nih.gov/40109285/?otool=iaurydwlib

https://hdl.handle.net/10137/14198

COVID-19

ICU

Mechanical Ventilation

Omicron

Outcomes

Pandemic

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

Journal Article

Publication