Critical Care Medicine

COVID Pandemic

The COVID-19 pandemic led to a unified and dedicated system response. Cleveland Clinic’s intensive care units worked as a team of teams to ensure all patients could be served according to evidence-based practices. The Medical Intensive Care Unit (MICU) was the epicenter for care for the sickest patients with COVID; during 2021, the MICU cared for 834 critically ill COVID patients. Outcomes in several metrics were affected by the pandemic as shown in COVID data below and overall metrics.

MICU COVID-19 Outcomes

March 2020 – December 2021

March 2020 — January 2021Total

March – December

2020

January – December

2021

Average APACHE® III score65.4666.5264.74
ICU survival81%82.6%80.5%
Hospital survival79%80.7%78.4%
Age-stratified hospital survival
  • ≥ 65 years old
64%64%64%
  • < 65 years old
78%82%76%
ICU survival of patients on invasive MV
  • ≥ 65 years old
54%58%50%
  • < 65 years old
72%76%71%
Average ICU LOS (days)7.26.87.5
Average hospital LOS (days)15.615.615.7
Average duration on MV (days)9.19.19.2

APACHE = Acute Physiology And Chronic Health Evaluation, a severity-of-disease classification system, LOS = length of stay, MICU = Medical Intensive Care Unit, MV = mechanical ventilation

The outcomes of critically ill patients admitted with COVID-19 infection to the MICU remained overall similar. COVID-19 patients had prolonged intensive care and hospital length of stay. Older patients had worse outcomes when critically ill or on mechanical ventilation.

MICU COVID Admissions

2020 – 2021ᵃ

MICU = Medical Intensive Care Unit

ᵃData from March 2020 to December 2021

Patients with COVID-19 were cared for in a cohort unit. This allowed teams to be trained and gain experience rapidly in care for this emerging disease while preserving continued access and care for other patients.