COVID-19 in critical care: epidemiology of the first epidemic wave across England, Wales and Northern Ireland

• DOI: 10.1007/s00134-020-06267-0
• Publication Date: 2020-10-09T07:02:51Z
• Authors: Alvin Richards-Belle; Izabella Orzechowska; Doug W. Gould; Karen Thomas; James C. Doidge; Paul R. Mouncey; Michael D. Christian; Manu Shankar-Hari; David A. Harrison; Kathryn M. Rowan; ; Yemi Banjo; Kasia Borowczak; Tom Cousins; Peter Cummins; Keji Dalemo; Robert Darnell; Hanna Demissie; Laura Drikite; Andrew Fleming; Ditte Frederiksen; Sarah Furnell; Abdo Hussein; Abby Koelewyn; Tim Matthews; Sam Peters; Tyrone Samuels; Michelle Saull
• Keywords: Male; Wales; Critical Care; Original; SARS-CoV-2; Pneumonia, Viral; COVID-19; Northern Ireland; Middle Aged; Critical Care and Intensive Care Medicine; State Medicine; 3. Good health; Cohort Studies; Betacoronavirus; Intensive Care Units; England; Humans; Female; Coronavirus Infections; Pandemics; Aged

To describe critical care patients with COVID-19 across England, Wales and Northern Ireland compare them a historic cohort of other viral pneumonias (non-COVID-19) international cohorts COVID-19.Extracted data on patient characteristics, acute illness severity, organ support outcomes from the Case Mix Programme, national clinical audit for adult care, prospective (February to August 2020) are compared recent retrospective (2017-2019) COVID-19, latter identified published reports.10,834 (70.1% male, median age 60 years, 32.6% non-white ethnicity, 39.4% obese, 8.2% at least one serious comorbidity) were admitted 289 units. Of these, 36.9% had PaO2/FiO2 ratio ≤ 13.3 kPa (≤ 100 mmHg) consistent severe ARDS 72% received invasive ventilation. Acute hospital mortality was 42%, higher than 5782 (24.7%), most deaths (88.7%) occurred before 30 days. Meaningful comparisons limited due lack standardised reporting.Critical disproportionately non-white, more deprived areas likely be male obese. Conventional severity scoring appeared not adequately reflect their distribution categories indicating acutely respiratory disease. Critical experience high place great burden services.