AUTHOR=Keller Karsten , Farmakis Ioannis T. , Valerio Luca , Koelmel Sebastian , Wild Johannes , Barco Stefano , Schmidt Frank P. , Espinola-Klein Christine , Konstantinides Stavros , Münzel Thomas , Sagoschen Ingo , Hobohm Lukas 

TITLE=Predisposing factors for admission to intensive care units of patients with COVID-19 infection—Results of the German nationwide inpatient sample

JOURNAL=Frontiers in Public Health

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1113793

DOI=10.3389/fpubh.2023.1113793

ISSN=2296-2565

ABSTRACT=<sec><title>Background</title><p>Intensive care units (ICU) capacities are one of the most critical determinants in health-care management of the COVID-19 pandemic. Therefore, we aimed to analyze the ICU-admission and case-fatality rate as well as characteristics and outcomes of patient admitted to ICU in order to identify predictors and associated conditions for worsening and case-fatality in this critical ill patient-group.</p></sec><sec><title>Methods</title><p>We used the German nationwide inpatient sample to analyze all hospitalized patients with confirmed COVID-19 diagnosis in Germany between January and December 2020. All hospitalized patients with confirmed COVID-19 infection during the year 2020 were included in the present study and were stratified according ICU-admission.</p></sec><sec><title>Results</title><p>Overall, 176,137 hospitalizations of patients with COVID-19-infection (52.3% males; 53.6% aged ≥70 years) were reported in Germany during 2020. Among them, 27,053 (15.4%) were treated in ICU. COVID-19-patients treated on ICU were younger [70.0 (interquartile range (IQR) 59.0–79.0) vs. 72.0 (IQR 55.0–82.0) years, <italic>P</italic> &lt; 0.001], more often males (66.3 vs. 48.8%, <italic>P</italic> &lt; 0.001), had more frequently cardiovascular diseases (CVD) and cardiovascular risk-factors with increased in-hospital case-fatality (38.4 vs. 14.2%, <italic>P</italic> &lt; 0.001). ICU-admission was independently associated with in-hospital death [OR 5.49 (95% CI 5.30–5.68), <italic>P</italic> &lt; 0.001]. Male sex [OR 1.96 (95% CI 1.90–2.01), <italic>P</italic> &lt; 0.001], obesity [OR 2.20 (95% CI 2.10–2.31), <italic>P</italic> &lt; 0.001], diabetes mellitus [OR 1.48 (95% CI 1.44–1.53), <italic>P</italic> &lt; 0.001], atrial fibrillation/flutter [OR 1.57 (95% CI 1.51–1.62), <italic>P</italic> &lt; 0.001], and heart failure [OR 1.72 (95% CI 1.66–1.78), <italic>P</italic> &lt; 0.001] were independently associated with ICU-admission.</p></sec><sec><title>Conclusion</title><p>During 2020, 15.4% of the hospitalized COVID-19-patients were treated on ICUs with high case-fatality. Male sex, CVD and cardiovascular risk-factors were independent risk-factors for ICU admission.</p></sec>