Lower levels of education and place of birth were associated with non-admission to the intensive care unit in Sweden during COVID-19 pandemic

1. Patients in Sweden with COVID-19 and lower levels of education or of Northwestern European or Northern American descent were at higher risk of non-admission to the intensive care unit (ICU).

Evidence Rating Level: 2 (Good)

Many patients throughout the COVID-19 pandemic required ICU level care, with withholding of treatment employed only if patients refuse treatment or if treatment is deemed futile. This retrospective, multicentre cohort study sought to investigate the incidence of non-admission to the ICU among patients in Sweden with COVID-19 based on socioeconomic factors. 20,764 patients from 5 centres in Sweden admitted to hospital with COVID-19 between March 2020 and February 2023 were included in the study. In total, 2823 (13.6%) of patients received non-admission to the ICU. Patients within the non-admission group were less likely to have completed tertiary education (584 [20.7%]) compared with patients not in the non-admission group (5578 [31.1%]). Further, patients within the non-admission group were more likely to have lived in a single-person household (1460 [51.7%]) compared with patients not in the non-admission group (5060 [28.2%]). Being born in Northwestern Europe or Northern America was also associated with increased risk of non-admission to the ICU (adjusted risk ratio 1.15 [95% CI, 1.06-1.26], p<0.01). Overall, this study found that among patients with COVID-19 in Sweden, lower level of education and being of Northwestern European or Northern American descent were associated with increased risk of ICU non-admission. 

Click here to read this study in BMJ Open

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