Influence of socioeconomic deprivation on interventions and outcomes for patients admitted with COVID-19 to critical care units in Scotland: a national cohort study

Background: Coronavirus disease 2019 (COVID-19) can lead to significant respiratory failure with between 14% and 18% of hospitalised patients requiring critical care admission. This study describes the impact of socioeconomic deprivation on 30-day survival following critical care admission for COVID-19, and the impact of the COVID-19 pandemic on critical care capacity in Scotland. Methods: This cohort study used linked national hospital records including ICU, virology testing and national death records to identify and describe patients with COVID-19 admitted to critical care units in Scotland. Multivariable logistic regression was used to assess the impact of deprivation on 30-day mortality. Critical care capacity was described by reporting the percentage of baseline ICU bed utilisation required. Findings: There were 735 patients with COVID-19 admitted to critical care units across Scotland from 1/3/2020 to 20/6/2020. There was a higher proportion of patients from more deprived areas, with 183 admissions (24.9%) from the most deprived quintile and 100 (13.6%) from the least deprived quintile. Overall, 30-day mortality was 34.8%. After adjusting for age, sex and ethnicity, mortality was significantly higher in patients from the most deprived quintile (OR 1.97, 95%CI 1.13, 3.41, p=0.016). ICUs serving populations with higher levels of deprivation spent a greater amount of time over their baseline ICU bed capacity. Interpretation: Patients with COVID-19 living in areas with greatest socioeconomic deprivation had a higher frequency of critical care admission and a higher adjusted 30-day mortality. ICUs in health boards with higher levels of socioeconomic deprivation had both higher peak occupancy and longer duration of occupancy over normal maximum capacity. Funding: None

Parafoveal processing of repeated words during reading

In an eye tracking experiment during reading, we examined the Repetition Effect whereby words that are repeated in the same paragraph receive shorter fixation durations. Target words that were either high- or low-frequency words and of which the parafoveal preview was either correct or with all letters replaced were embedded three times in the same paragraph. Shorter fixation times and higher skipping rates were observed for high-frequency compared to low- frequency words, words for which the parafoveal preview was correct versus incorrect and as the word was being repeated more often. An interaction between frequency and repetition indicated that the reduction in fixation times due to repetition was more pronounced for low- frequency words. We also observed influences of word repetition on parafoveal processing as repeated words were skipped more often. An interaction between parafoveal preview and repetition indicated an absent repetition effect when the preview was incorrect but this effect was short-lived as it was restricted to the first fixation duration on the target word

Prevalence, characteristics and longer-term outcomes of patients with persistent critical illness due to COVID-19 in Scotland: a national cohort study

Background: Patients with coronavirus disease (COVID-19) can require critical care for prolonged periods. Patients with Persistent Critical Illness can have complex recovery trajectories but this has not been researched for patients with COVID-19. We examined the prevalence, risk factors and long-term outcomes of critically ill COVID-19 patients with persistent critical illness. Methods: A national cohort study of all adults admitted to Scottish critical care units with COVID-19 from 01/03/20 to 04/09/21. Persistent critical illness was defined as a critical care length of stay (LOS) of ≥10 days. Outcomes included one-year mortality and hospital readmission following critical care discharge. Fine and Gray competing risk analysis was used to identify factors associated with Persistent Critical Illness with death as a competing risk. Results: 2236 patients with COVID-19 were admitted to critical care. 1045 patients were identified as developing Persistent Critical Illness, comprising 46.7% of the cohort but using 80.6% of bed-days. Persistent Critical Illness patients used more organ support, had longer post-critical care LOS and longer total hospital LOS. Persistent critical illness was not significantly associated with long-term mortality or hospital readmission. Risk factors associated with increased hazard of Persistent Critical Illness include age, illness severity, organ support on admission and fewer comorbidities. Conclusion: Almost half of all critical care patients with COVID-19 develop persistent critical illness, with high resource use in critical care and beyond. However, persistent critical illness was not associated with a significantly worse long-term outcomes compared to patients who were critically ill for shorter periods

COVID-19 infection and maternal morbidity in critical care units in Scotland: a national cohort study

No abstract available