<h3>Background:</h3> The COVID-19 pandemic has brought unprecedented challenges and changes to worldwide healthcare systems, compelling a re-evaluation of clinical practices. This study aims to characterize the intensive care unit (ICU) patients evaluated by the rheumatology service at a fourth-level clinic in Cali-Colombia and compare consultation dynamics and clinical outcomes before and after the pandemic's beginning. <h3>Objectives:</h3> To describe and compare the sociodemographic and clinical characteristics and the adverse outcomes among ICU patients assessed by the rheumatology service at a Colombian hospital, pre and post COVID-19 pandemic. <h3>Methods:</h3> This single-center and retrospective study analyzed rheumatology consultations in ICU patients between 2012-2020 and 2021-2023 at a fourth-level clinic in Cali, Colombia. Patients were categorized into four groups based on their diagnosis status: Group 0, patients with new onset diagnosed systemic autoimmune rheumatic diseases (SARDs); Group 1, patients with known diagnosed SARDs; Group 2, patients without diagnosed SARDs; and Group 3, patients with unconfirmed suspicion of SARDs. The primary outcomes included were in-hospital mortality, nosocomial infections, and hospital readmission. Descriptive and comparative analyses were performed. <h3>Results:</h3> The study enrolled 215 ICU patients requiring rheumatology assessment. After COVID-19, consultations increased, with an average of 34.6 per year from 2021 to 2023, compared to 13.8 between 2012 and 2019. The group 0 increased after COVID-19 (6.3% in a shorter period). Meanwhile, group 3 declined significantly. In-hospital mortality, nosocomial infections, and hospital readmission were not statistically different among the two evaluated periods (Table 1). Figure 1 shows the patients with composite adverse outcomes (in-hospital mortality, nosocomial infections, or hospital readmission) divided by investigation groups and pre or post-pandemic. <h3>Conclusion:</h3> The rise in rheumatology consultations post-pandemic coincided with changes in hospital politics regarding the type of admitted population. However, the rheumatology group has noticed an increase in patients with new-onset SARDs after the pandemic. It is paramount that the patients evaluated post-pandemic were younger, as it impacts social and economic aspects. Lower hemoglobin levels have been a parameter associated with adverse outcomes in hospital and ICU patients; the change demonstrated between the two evaluated periods was favorable and could impact the examined adverse outcomes. The use of masks and the improvement in hand hygiene could be directly involved in the significant change in the proportion of patients with community-acquired infections before and after the COVID-19 pandemic. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>