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People in intensive care with COVID-19: demographic and clinical features during the first, second, and third pandemic waves in Australia.
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.
  • Begum H; Monash University, Melbourne, VIC.
  • Neto AS; Australian and New Zealand Intensive Care Research Centre, Melbourne, VIC.
  • Alliegro P; Alfred Health, Melbourne, VIC.
  • Broadley T; Monash University, Melbourne, VIC.
  • Trapani T; Monash University, Melbourne, VIC.
  • Campbell LT; Alfred Health, Melbourne, VIC.
  • Cheng AC; Royal Darwin Hospital, Darwin, NT.
  • Cheung W; Menzies School of Health Research, Darwin, NT.
  • Cooper DJ; Monash University, Melbourne, VIC.
  • Erickson SJ; Concord Repatriation General Hospital, Sydney, NSW.
  • French CJ; Monash University, Melbourne, VIC.
  • Litton E; Australian and New Zealand Intensive Care Research Centre, Melbourne, VIC.
  • McAllister R; Alfred Health, Melbourne, VIC.
  • Nichol A; Princess Margaret Hospital for Children, Perth, WA.
  • Palermo A; Western Heath, Melbourne, VIC.
  • Plummer MP; Fiona Stanley Hospital, Perth, WA.
  • Rotherham H; Royal Hobart Hospital, Hobart, TAS.
  • Ramanan M; Monash University, Melbourne, VIC.
  • Reddi B; Alfred Health, Melbourne, VIC.
  • Reynolds C; Fiona Stanley Hospital, Perth, WA.
  • Webb SA; St John of God Health Care, Perth, WA.
  • Udy AA; Royal Melbourne Hospital, Melbourne, VIC.
  • Burrell A; Royal Melbourne Hospital, Melbourne, VIC.
Med J Aust ; 217(7): 352-360, 2022 10 03.
Article in English | MEDLINE | ID: covidwho-1884637
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.
Subject(s)
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Observational study / Prognostic study Topics: Variants Limits: Humans / Male / Middle aged Country/Region as subject: Oceania Language: English Journal: Med J Aust Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Observational study / Prognostic study Topics: Variants Limits: Humans / Male / Middle aged Country/Region as subject: Oceania Language: English Journal: Med J Aust Year: 2022 Document Type: Article