COVID-19 critical illness in Sweden: characteristics and outcomes at a national population level

Objective: During the coronavirus disease 2019 (COVID-19) pandemic, baseline demographics and comorbidities of patients with COVID-19 have been presented, but there are limited data on outcomes of severely ill patients We aimed to examine the association between patient characteristics and 30-day mortality among patients with COVID-19 treated in the intensive care unit (ICU) Design: Population-based cohort study Setting: ICUs in Sweden Participants: All consecutive patients with COVID-19 admitted to Swedish ICUs from 6 March to 5 April 2020 Main outcome measures: The primary outcome was 30-day mortality after ICU admission Patient demographics, comorbidities and clinical characteristics were also retrieved Results: A total of 604 patients were included The median age was 61 years (interquartile range [IQR], 52-70 years) and 458 patients (76%) were males The most common comorbidities were hypertension (35 9%) and diabetes (25 7%), whereas 36 4% of patients had no comorbidities Median Simplified Acute Physiology Score (SAPS) 3 was 53 (IQR, 46-60) Of 573 patients with available respiratory support data, 487 (85 0%) received invasive mechanical ventilation Among 518 patients with available data, 117 (22 6%) received renal replacement therapy Median length of stay was 13 days (IQR, 6-20 days) Mortality at 30 days was 32 6% In the multivariable Cox regression model, age (hazard ratio [HR] 1 06;95% CI, 1 04-1 07 per year), the presence of one or more comorbidities (HR, 1 80;95% CI, 1 20-2 68), chronic obstructive pulmonary disease or asthma (HR, 1 68;95% CI, 1 12-2 50), hypertension (HR, 1 41;95% CI, 1 01-1 99), and acute illness severity (SAPS 3 excluding age and comorbidity) (HR, 1 06;95% CI, 1 04-1 09) were associated with 30-day mortality Conclusions: This population-based cohort study presents 30-day mortality of 604 ICU patients with COVID-19 The higher mortality was explained by older age, the presence chronic illness, and acute illness severity