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Letter
Implications for COVID-19 triage from the ICNARC report of 2204 COVID-19 cases managed in UK adult intensive care units
  1. Claire L Shovlin1,2,
  2. Marcela P Vizcaychipi3,4
  1. 1 NHLI Vascular Science, Imperial College London, London, UK
  2. 2 Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK
  3. 3 Department of Anaesthesia and Intensive Care, Chelsea and Westminster Hospital NHS Foundation Trust, London, London, UK
  4. 4 Department of Surgery and Cancer, Imperial College London, London, UK
  1. Correspondence to Professor Claire L Shovlin, London, UK; c.shovlin{at}imperial.ac.uk; Dr Marcela P Vizcaychipi; Marcela.Vizcaychipi{at}chelwest.nhs.uk

https://doi.org/10.1136/emermed-2020-209791

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    On 4 April 2020, the Intensive Care National Audit and Research Centre (ICNARC) reported data from 286 adult intensive care units (AICUs) across England, Wales and Northern Ireland.1 Of 2204 patients admitted with COVID-19, 1524/2204 (69%) remained on AICU, 340 (15.4%) had been discharged and 340 (15.4%) had died.1 These survival rates emphasise the crucial importance of intensive/critical care support for patients most severely affected by COVID-19.

    The 2204 COVID-19 cases were compared with 4759 patients with non COVID-19 viral pneumonia admitted to the same AICUs in the previous 3 years.1 The striking difference was that prior to their respective illnesses, the COVID-19 cohort was significantly healthier, with much lower disease burdens in the preceding 6 months (figure 1).

    Figure 1

    COVID-19 and non-COVID cases in the Intensive Care National Audit and Research Centre (ICNARC) report of 4 April 2020.1 Percentage of total cases with the respective disease burden within the 6 months prior to critical care, as defined by ICNARC1: immunocompromise: chemotherapy, radiotherapy or daily high dose steroid treatment in previous 6 months, HIV/AIDS or congenital …

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    Footnotes

    • Contributors Conception and design: both authors. Analysis and interpretation: both authors. Drafting the manuscript for important intellectual content: both authors. In detail: both authors performed literature searches and designed the work based on clinical experience, particularly from MPV. CS performed the data analysis and wrote the first draft. Both authors contributed to data interpretation and manuscript revisions before joint approval.

    • Funding The study received no specific funding support. CLS acknowledges support from the National Institute of Health Research Biomedical Research Centre Scheme (Imperial BRC).

    • Competing interests None declared.

    • Patient and public involvement Focusing of data interpretation towards the triaging of patients was an outcome of inputs from British patients contacting CLS, focusing on the question 'Am I at High Risk?'.

    • Patient consent for publication Not required.

    • Ethics approval No ethics approvals were required.

    • Provenance and peer review Not commissioned; internally peer reviewed.