• Michelle S Chew, Patrik Johansson Blixt, Rasmus Åhman, Lars Engerström, Henrik Andersson, Ritva Kiiski Berggren, Anders Tegnell, and Sarah McIntyre.
• From the Departments of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences (MSC, PJB, RÅ, HA), Department of Anaesthesia and Intensive Care, Vrinnevi Hospital, Norrköping, Department of Thoracic and Vascular Surgery, Medical and Health Sciences, Linköping University (LE), Department of Anaesthesia, Intensive Care and Perioperative Services, Umeå University Hospital, Umeå (RKB), Department of Public Health Reporting, Public Health Agency of Sweden (AT), Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience, Linköping University, Sweden (SM).
• Eur J Anaesthesiol. 2021 Apr 1; 38 (4): 335-343.

BackgroundMortality among patients admitted to intensive care units (ICUs) with COVID-19 is unclear due to variable follow-up periods. Few nationwide data are available to compare risk factors, treatment and outcomes of COVID-19 patients after ICU admission.ObjectiveTo evaluate baseline characteristics, treatments and 30-day outcomes of patients admitted to Swedish ICUs with COVID-19.DesignRegistry-based cohort study with prospective data collection.SettingAdmissions to Swedish ICUs from 6 March to 6 May 2020 with laboratory confirmed COVID-19 disease.ParticipantsAdult patients admitted to Swedish ICUs.ExposuresBaseline characteristics, intensive care treatments and organ failures.Main Outcomes And MeasuresThe primary outcome was 30-day all-cause mortality. A multivariable model was used to determine the independent association between potential predictor variables and death.ResultsWe identified 1563 patients with complete 30-day follow-up. The 30-day all-cause mortality was 26.7%. Median age was 61 [52 to 69], Simplified Acute Physiology Score III (SAPS III) was 53 [46 to 59] and 62.5% had at least one comorbidity. Median PaO2/FiO2 on admission was 97.5 [75.0 to 140.6] mmHg, 74.7% suffered from moderate-to-severe acute respiratory failure. Age, male sex [adjusted odds ratio (aOR) 1.5 (1.1 to 2.2)], SAPS III score [aOR 1.3 (1.2 to 1.4)], severe respiratory failure [aOR 3.0 (2.0 to 4.7)], specific COVID-19 pharmacotherapy [aOR 1.4 (1.0 to 1.9)] and continuous renal replacement therapy [aOR 2.1 (1.5 to 3.0)] were associated with increased mortality. Except for chronic lung disease, the presence of comorbidities was not independently associated with mortality.ConclusionsThirty-day mortality rate in COVID-19 patients admitted to Swedish ICUs is generally lower than previously reported despite a severe degree of hypoxaemia on admission. Mortality was driven by age, baseline disease severity, the presence and degree of organ failure, rather than pre-existing comorbidities.Trial Registration NoNCT04462393.Copyright © 2021 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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