Non-COVID-19 intensive care admissions during the pandemic: A multinational registry-based study

Joshua McLarty, Edward Litton, Abi Beane, David V Pilcher, Jorge I.F. Salluh, Rashan Haniffa, Nazir I Lone

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

The COVID-19 pandemic resulted in a large number of critical care admissions. While national reports have described the outcomes of COVID-19 patients, there is limited international data of the pandemic impact on non-COVID-19 patients requiring intensive care treatment.
We conducted an international, retrospective cohort study using 2019 and 2020 data from 11 national Clinical Quality Registries covering 15 countries. Non-COVID-19 admissions in 2020 were compared to all admissions in 2019, pre-pandemic. The primary outcome was intensive care unit (ICU) mortality. Secondary outcomes included in-hospital mortality, and standardised mortality ratio (SMR). Analyses were stratified by the country income level(s) of each registry.
Amongst 1,642,632 non-COVID-19 admissions, there was an increase in ICU mortality between 2019 (9.3%) and 2020 (10.4%), odds ratio (OR)=1.15 (95% CI 1.14–1.17, pIncreased mortality was observed in middle-income countries (OR 1.25 95% CI 1.23-1.26), while mortality decreased in high-income countries (OR=0.96 95% CI 0.94-0.98). Hospital mortality and SMR trends for each registry were consistent with the observed ICU mortality findings. The burden of COVID-19 was highly variable, with COVID-19 ICU patient-days per bed ranging from 0.4 to 81.6 between registries. This alone did not explain the observed non- COVID-19 mortality changes.
Increased ICU mortality occurred amongst non-COVID-19 patients during the pandemic, driven by increased mortality in middle-income countries, while mortality decreased in highincome countries. The causes for this inequity are likely multi-factorial, but healthcare
Original languageEnglish
Early online date24 May 2023
Publication statusE-pub ahead of print - 24 May 2023


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