• Marilena Marmiere, Margherita Rocchi, Marco Saracino, Filippo D'Amico, Roberta Stati, and Giovanni Landoni.
• Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
• Minerva Anestesiol. 2022 Dec 1; 88 (12): 103010341030-1034.

BackgroundThe percentage of overall COVID-19 deaths which occurred in intensive care units (ICU) is unknown. We estimated 18% in Italy from February 21, 2020, to February 21, 2021, using cumulative numbers from publicly available databases. This study aims to confirm this percentage using raw data from Italian and European registries.MethodsWe searched PubMed, government health reports, and medical websites to obtain the ratio between number of COVID-19 deaths in ICUs and total number of COVID-19 deaths in the most hit European regions during the first year of the pandemic. When available, we distinguished between different waves and interwaves periods. We performed a forest plot with random effect of proportions to calculate the overall European percentage.ResultsWe found data for six European countries (United Kingdom, Netherlands, Norway, Italy, Denmark, and Germany). The percentage of COVID-19 deaths which occurred in United Kingdom ICUs was 10% and 11% during the first and the second pandemic waves, respectively. Netherlands and Norway counted 13% and 16%. Italy had 18% of the overall COVID-19 deaths occurring in the ICU during both pandemic waves, and 17% during the intra-pandemic period. Denmark and Germany counted 20% and 22%. Overall, 16% of the COVID-19 deaths occurred in European ICUs.ConclusionsThe percentage of COVID-19 deaths which occurred in European ICUs was 16% and consistent across different countries, ranging from 10% to 22%. Interestingly, we observed no difference between pandemic waves and intra-pandemic periods.

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