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Title: People in intensive care with COVID-19: demographic and clinical features during the first, second, and third pandemic waves in Australia.
Authors: Begum, Husna
Neto, Ary S
Alliegro, Patricia
Broadley, Tessa
Trapani, Tony
Campbell, Lewis T
Cheng, Allen C
Cheung, Winston
Cooper, D James
Erickson, Simon J
French, Craig J
Litton, Edward
McAllister, Richard
Nichol, Alistair
Palermo, Annamaria
Plummer, Mark P
Rotherham, Hannah
Ramanan, Mahesh
Reddi, Benjamin
Reynolds, Claire
Webb, Steven Ar
Udy, Andrew A
Burrell, Aidan
Citation: © 2022 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.
Med J Aust. 2022 Jun 9. doi: 10.5694/mja2.51590.
Abstract: OBJECTIVE: To compare the demographic and clinical features, management, and outcomes for patients admitted with COVID-19 to intensive care units (ICUs) during the first, second, and third waves of the pandemic in Australia. DESIGN, SETTING, AND PARTICIPANTS: People aged 16 years or more admitted with polymerase chain reaction-confirmed COVID-19 to the 78 Australian ICUs participating in the Short Period Incidence Study of Severe Acute Respiratory Infection (SPRINT-SARI) Australia project during the first (27 February - 30 June 2020), second (1 July 2020 - 25 June 2021), and third COVID-19 waves (26 June - 1 November 2021). MAIN OUTCOME MEASURES: Primary outcome: in-hospital mortality. SECONDARY OUTCOMES: ICU mortality; ICU and hospital lengths of stay; supportive and disease-specific therapies. RESULTS: 2493 people (1535 men, 62%) were admitted to 59 ICUs: 214 during the first (9%), 296 during the second (12%), and 1983 during the third wave (80%). The median age was 64 (IQR, 54-72) years during the first wave, 58 (IQR, 49-68) years during the second, and 54 (IQR, 41-65) years during the third. The proportion without co-existing illnesses was largest during the third wave (41%; first wave, 32%; second wave, 29%). The proportion of ICU beds occupied by patients with COVID-19 was 2.8% (95% CI, 2.7-2.9%) during the first, 4.6% (95% CI, 4.3-5.1%) during the second, and 19.1% (95% CI, 17.9-20.2%) during the third wave. Non-invasive (42% v 15%) and prone ventilation strategies (63% v 15%) were used more frequently during the third wave than during the first two waves. Thirty patients (14%) died in hospital during the first wave, 35 (12%) during the second, and 281 (17%) during the third. After adjusting for age, illness severity, and other covariates, the risk of in-hospital mortality was similar for the first and second waves, but 9.60 (95% CI, 3.52-16.7) percentage points higher during the third than the first wave. CONCLUSION: The demographic characteristics of patients in intensive care with COVID-19 and the treatments they received during the third pandemic wave differed from those of the first two waves. Adjusted in-hospital mortality was highest during the third wave.
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Journal title: The Medical journal of Australia
Publication Date: 2022-06-09
Type: Journal Article
DOI: 10.5694/mja2.51590
Orcid: 0000-0003-3152-116X
Appears in Collections:(a) NT Health Research Collection

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