How many of the COVID-19 deaths occurred in the Intensive Care Unit?

BACKGROUND: The percentage of overall COVID-19 deaths which occurred in intensive care units (ICU) is unknown. We estimated 18% in Italy from February 21, 2020, to February 21, 2021, using cumulative numbers from publicly avail-able databases. This study aims to confirm this percentage using raw data from Italian and European registries.METHODS: We searched PubMed, government health reports, and medical websites to obtain the ratio between number of COVID-19 deaths in ICUs and total number of COVID-19 deaths in the most hit European regions during the first year of the pandemic. When available, we distinguished between different waves and interwaves periods. We performed a forest plot with random effect of proportions to calculate the overall European percentage.RESULTS: We found data for six European countries (United Kingdom, Netherlands, Norway, Italy, Denmark, and Germany). The percentage of COVID-19 deaths which occurred in United Kingdom ICUs was 10% and 11% during the first and the second pandemic waves, respectively. Netherlands and Norway counted 13% and 16%. Italy had 18% of the overall COVID-19 deaths occurring in the ICU during both pandemic waves, and 17% during the intra-pandemic period. Denmark and Germany counted 20% and 22%. Overall, 16% of the COVID-19 deaths occurred in European ICUs.CONCLUSIONS: The percentage of COVID-19 deaths which occurred in European ICUs was 16% and consistent across different countries, ranging from 10% to 22%. Interestingly, we observed no difference between pandemic waves and intra-pandemic periods.(Cite this article as: Marmiere M, Rocchi M, Saracino M, D'Amico F, Stati R, Landoni G. How many of the COVID-19 deaths occurred in the Intensive Care Unit? Minerva Anestesiol 2022;88:1030-4. DOI: 10.23736/S0375-9393.22.16600-9)