Low Mortality Rates Among Critically Ill Adults with COVID-19 at Three Non-academic Intensive Care Units in South Sweden

Background: The COVID-19 pandemic has put an exceptional strain on intensive care units worldwide. During the first year, the survival of patients with acute hypoxaemic respiratory failure appears to have improved. We aimed to describe the mortality rates, management characteristics and two pandemic waves during the first year at three non-academic rural intensive care units in Sweden.

Methods: We retrospectively analysed all cases of COVID-19 admitted to intensive care units in Region Jönköping County during 1 year. The primary endpoint was 30-day mortality.

Results: Between 14th March 2020 and 13th March 2021, 264 patients were admitted to undergo intensive care with confirmed SARS-CoV-2 infection. The 30-day mortality rate after the initial intensive care admission was 12.9%, and this rate remained unchanged during both pandemic waves. However, we found several distinct differences between the two pandemic waves, including an increase in the use of high-flow nasal oxygen but a decrease in invasive mechanical ventilation use, biochemical markers of inflammation, continuous renal replacement therapy and length of stay in the intensive care unit.

Conclusion: Our study showed that critically ill patients with COVID-19 in Sweden have a low 30-day mortality rate which compares well with results published from academic centres and national cohorts throughout Scandinavia. During the second pandemic wave, the proportion of patients receiving invasive mechanical ventilation and continuous renal replacement therapy was lower than that in the first wave. This could be the result of increased knowledge and improved therapeutic options.