Scottish Intensive Care Society Audit Group report on COVID-19
As at 11 January 2022

About this release

This release by Public Health Scotland is the ninth 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 9 January 2022 there were 2,933 patients with a laboratory confirmed positive PCR test for COVID-19 admitted to intensive care units (ICUs) in Scotland. Of these, 1,087 patients have been admitted to ICUs since 18 May 2021, defined as the start of the third wave in this report.

Daily count of ICU admissions with COVID-19 from 1st March 2020 to 9th January 2022.

Close

Number of ICU admissions with COVID-19

• Clinical management of patients in ICU continued to evolve as findings from research studies were rapidly adopted. A higher proportion of patients in wave 3 were managed with non-invasive ventilation on admission to ICU (43% in waves 1 and 2 compared with 55% in wave 3) with a corresponding reduction in the use of advanced respiratory support (45% in waves 1 and 2 vs 30% in wave 3).
• One in five patients (22%) 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, 30% in wave 3).
• During wave 3, 548 patients were admitted with a laboratory confirmed positive PCR test for COVID-19 to ICUs more than 14 days after receiving the second dose of a vaccine. 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.
• 75 pregnant or recently pregnant women were admitted to ICUs and general HDUs after testing positive for COVID-19 (51 in wave 3). Fewer than 5 women had received either one or two doses of the COVID-19 vaccine before admission. 44% required advanced respiratory support and over half required non-invasive respiratory support. One death had been reported by 9 January 2022.
• A survey of Scottish ICUs undertaken on 13 January 2022 found that 72% of ICUs were able to maintain recommended nurse-to-patient staffing ratios with ICU-trained registered nurses from their own unit. Overall, only 73% of the expected number of ICU-trained registered nurses from their own unit were working on the unit on the day of the survey.
• During the period 1 March 2020 to 9 January 2022 there were 2,051 patients with a laboratory confirmed positive PCR test for COVID-19 admitted to high dependency units (HDUs) in Scotland. Of these patients, 753 were admitted in wave 3. In wave 3, 30-day mortality was lower in HDU patients compared with ICU patients (26% compared with 35%).

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 eighth report compares characteristics and outcomes for admissions between the first, second and third 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.