The study Survival rates and long-term outcomes for patients with COVID-19 admitted to Norwegian ICUs has two different aims. The first aim was to synthesis data from a National register (Norwegian Intensive care-and Pandemic register) on all COVID-19 patients in Norway admitted to an ICU.
Results from the three first waves (spring-20, autumn 20, spring-21) of the pandemic, showed a higher mortality rate during autumn-20, that cannot be explained by factors such as age or severity of disease. The use of non-invasive mechanical ventilation increased during the period and ICU length of stay decreased.
The second part of the study was a follow-up study of ICU survivors during the first year after admission. We have investigated symptoms of post traumatic stress at 6 months, in patients surviving the first wave, and we could not find that the frequency among this COVID-19 population was higher than seen in previous ICU populations. However, quite a large proportion of the patients did report some degree of mild cognitive dysfunction (e.g., concentration difficulties). We will now start to investigate the level of fatigue in the total ICU population admitted until June 2021.
The results from this study have contributed to increased knowledge on both patient characteristics, treatment modalities, survival rates, risk factors and long-term outcome for the new patient population (COVID-19). Results from this study can be used in both preparing for new viral pandemics in term of planning for ICU capacity, treatment modalities and rehabilitation services. In addition, the study results can also be used to inform the public about the long-term consequences of ICU treatment.
The study will be conducted as a collaborative study between Norwegian Intensive Care Register (NIR) and Oslo University Hospital. The study will explore and describe the Norwegian ICU-population with COVID-19. NIR is one of several national quality registries in the Norwegian health care system. Registration is mandatory for all ICU-admissions fulfilling specific criteria. This will increase the generalizability of the results. The data collected during the COVID-19 epidemic may also be compared to existing NIR data, particularly those obtained from previously registered influenza patients, to identify similarities and discrepancies in the management and outcomes in these groups of patients.
Respiratory failure is the main cause of ICU-admission for COVID-19 patients. The present project will also collect follow-up data from the NIR registry for all survivors of COVID-19. The negative consequences of surviving an ICU stay has received increased attention in recent years, as decreased mortality rates have contributed to a high number of ICU survivors. It has been reported that survivors of ARF of any aetiology report substantial impairment in physical functioning and quality of life (QOL) up to 5 years after ICU discharge.
The one-year follow-up study will include questionnaires that captures physical, psychological and mental health related challenges occurring after ICU treatment.