Background and objective:
Gauteng Province was the South African epicentre during the coronavirus disease 2019(COVID-19) pandemic and subsequently experienced high rates of severe COVID-19 cases and hospitalisations, including intensive care unit(ICU) admissions. ICU beds are a scarce and costly resource in South Africa, and the increased demand and utilization during the COVID-19 pandemic provided an opportunity for further analyses to potentially inform future patient management and ICU policies.

Methods:
A retrospective, observational, cohort study was conducted using COVID-19 hospital surveillance data for Gauteng. Demographic and clinical factors were described. Predictors of mortality were determined using logistic regression analyses.

Results:
Of the 158737 patients hospitalised with COVID-19 from 6/03/2020 to 27/11/2022 in Gauteng, 8.8%(n=13907) were admitted into an Intensive Care Unit(ICU). Of these patients, 56.0%(n=7784) were male and 67.1%(n=9337) were aged 50 years and over. Using national, official definitions for COVID-19 waves, the last(fourth) wave in Gauteng ended on 31/12/2021. A total of 8796 patients were admitted into ICUs during all four COVID-19 waves in the province. The majority of ICU admissions[38,5%;n=3386] occurred during the third wave(27/05/2021-11/08/2021), when the SARS-CoV-2 Delta variant was the predominantly circulating viral strain. Most ICU admissions were into private-sector hospitals[88.6%;12316]. 5465(39.3%) of ICU admissions received mechanical ventilation, of which 83.5%(4561) was in private-sector facilities. 7588(54.6%) patients received supplemental oxygen therapy. Statistically significant (p-value