Scottish Intensive Care Society Audit Group report on COVID-19
As at 23 September 2021

About this release

This release by Public Health Scotland is the eighth report on data from the Scottish Intensive Care Society Audit Group (SICSAG) relating to patients admitted to intensive care units (ICUs) and high dependency units (HDUs) across Scotland with COVID-19. This report differs from data published on 08 July 2020 and earlier relating to patients admitted to Scottish ICUs with COVID-19 disease, as it only includes those patients whose laboratory test was positive in the 21 days before critical care admission or during the critical care stay. In this report wave 1 is defined as 1 March 2020 to 31 July 2020, wave 2 is defined 1 August 2020 to 17 May 2021, and wave 3 is defined as starting from 18 May 2021.

Main points

During the period 1 March 2020 to 19 September 2021

• 2,389 patients with laboratory confirmed COVID-19 disease admitted to intensive care units (ICUs) in Scotland. Of these, 539 patients have been admitted to ICUs during wave 3.

• One in four patients (27%) were aged under 40 years old in wave 3 compared with 8% in waves 1 and 2. Mortality measured at 30-days after ICU admission was lower in wave 3 (37% in waves 1 and 2, 26% in wave 3).
• 192 patients were admitted to ICUs more than 14 days after receiving the second dose of a vaccine, equivalent to 0.4 ICU admissions per week per 100,000 adult population. In the unvaccinated adult population, there were 2.2 ICU admissions per week per 100,000 population. Unvaccinated people were around 6 times more likely to be admitted to ICUs with a positive COVID-19 test than people who had received both doses of the COVID-19 vaccine.
• A survey of Scottish ICUs undertaken on 23 September 2021 found that 39% of ICUs were able to maintain recommended nurse-to-patient staffing ratios with ICU-trained registered nurses from their own unit. In the remaining 61% of units, staffing ratios could only be maintained with registered nursing staff who did not usually work in the ICU.
• There were 1,649 patients with laboratory confirmed COVID-19 disease admitted to HDUs. Of these, 351 were admitted in wave 3. In wave 3, 30-day mortality was lower in HDU patients compared with ICU patients (20% compared with 26%).

Background

The Scottish Intensive Care Society Audit Group (SICSAG) is the national adult critical care audit and quality assurance programme. It benefits from a close collaboration between the Scottish Intensive Care Society and Public Health Scotland. The audit has complete, national coverage of all admissions to intensive care units (ICUs) and combined critical care units in Scotland.

Since the start of the COVID-19 outbreak, SICSAG has transformed its systems to provide daily data to inform the response to the pandemic across Scotland. The full report describes the admission frequency, demographics, activity and outcomes for patients with laboratory confirmed COVID-19 disease admitted to Scottish units. It includes admissions to adult ICUs, combined intensive care/high dependency units, and areas of hospitals which have been repurposed to provide intensive care. In this report, the term ‘ICU’ refers to these three types of facility. It also includes admissions to standalone adult high dependency units (HDUs), as well as areas of hospitals which have been repurposed to provide high dependency care. However, not all repurposed HDUs were able to contribute data to the audit. The report does not include admissions to paediatric/neonatal ICUs and HDUs.

This seventh report compares characteristics and outcomes for admissions between the first and second waves of the pandemic.

Further information

Further information is available from the SICSAG website.

The next release of this publication will be on an ad hoc basis.