ABSTRACT
Following COVID-19 pandemic, rationning in intensive care unit (ICU) became common. This can lead to delay ICU admissions of severe patients and affect global prognosis. we aimed to assess clinical characteristics and outcomes of COVID-19 patients requiring ICU admission in terms of hospitalisation's delay. This study was performed at the zaghouan's hospital ICU, a 10-bed secondary ICU in Tunisia. It was a retrospective observationnal study including all severly COVID-19 patients admitted between March 20th, 2020 and February 15th, 2022. 2 groups were identified : Early ICU transfer (G1) was defined as admission within 48 hours of hospital stay, and late transfer (G2) was defined as an admission after 48 hours of hospital stay. During the study period, 1609 patients had required hospitalisation in our hospital, among them 365 (22.7%) were secondary transfered to ICU. A total of 163 patients were included in G1 and 202 patients were assigned to G2. Comorbidities were similar between the 2 groups. Mean ages were respectively 54.7+/-14.8 vs 58+/-12.5 years (p=0.019). Means SAPS II and APACHE II scores were respectively 22.3+/-9 vs 24+/-8.5 (p=0.03) and 7.5+/-4 vs 7.6+/-4.5 (p=0.8). On ICU admission, PaO2/FiO2 was higher in G1 (137+/-84mmHg vs 128+/-77 mmHg, p=0.4). There was no difference in ventilatory strategy between the two groups. Need for tracheal intubation was lower in G1 (37.4% vs 44%) (p=0.25). Length of ICU stay was similar in two groups (8.8+/-3.4 days vs 9+/-4.5 days). In-ICU mortality was significantly lower in G1 (35.6% vs 48.5%;p=0.028). Delay of ICU admission was associated with higher mortality. Better organizaion was needed to establisch optimal decision-making process.