More COVID-19 Patients in ICUs Are Surviving Now: Study

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By E.J. Mundell
HealthDay Reporter

WEDNESDAY, July 15, 2020 (HealthDay News)

Even as new coronavirus infections soar in the United States, a study released Wednesday offered one piece of good news: Severely ill COVID-19 patients are significantly more likely to survive now compared to a few months ago.

In fact, deaths for COVID-19 patients in intensive care units have fallen by nearly a third in North America, Asia and Europe since the start of the pandemic, researchers report.

Overall, ICU deaths fell from nearly 60% at the end of March to 42% by the end of May.

That translates to tens of thousands of lives saved and “may reflect the rapid learning that has taken place on a global scale” of what drugs work (for example, remdesivir and dexamethasone) or don’t (hydroxychloroquine) to beat back COVID-19, according to a team led by Tim Cook. He’s a consultant in anesthesia and intensive care medicine at Royal United Hospitals Bath NHS Foundation Trust in England.

But just because fewer very ill COVID-19 patients are dying doesn’t mean societies can become complacent about the threat, experts said.

“Any successful treatment, when not coupled with good public health measures to keep the new case rate below the limit of existing health care resources, will erase any gains made over the last few months by simply overwhelming the ICUs that have just become better at treating COVID-19,” stressed Dr. Eric Cioe Pena. He directs global health at Northwell Health in New Hyde Park, N.Y.

Indeed, COVID-19 death rates are beginning to rise again in the United States, despite improvements in care. By Wednesday, the U.S. coronavirus case count passed 3.4 million as the death toll passed 136,000, according to a New York Times tally.

And after plateauing earlier this month, U.S. death counts are rising again. By Monday five states — Arizona, California, Florida, Mississippi and Texas — broke records for average daily COVID-19 fatalities over the past week, the Washington Post reported.

Still, if you are unlucky enough to land in an ICU with COVID-19, your odds of leaving alive are better now, Cook and his team found.

Their report was based on an analysis of 24 studies from around the world, involving more than 10,000 patients. All studies focused on ICU deaths among adults battling COVID-19 published up to May 31.

The data suggest that the credit for improved survival doesn’t rest with any one specific therapy, the researchers said. They published their findings July 15 in the journal Anaesthesia.

Still, something must have changed over the study period. Besides all the new data on what drug therapies may help beat COVID-19, “it may also be that ICU admission criteria have changed over time, for example, with greater pressure on ICUs early in the pandemic surge,” Cook said in a journal news release.

His team also noted that longer ICU stays for COVID-19 patients take time to be reflected in the published data. In fact, severe COVID-19 illness can last for long periods, with about 20% of COVID-19 ICU admissions in the United Kingdom lasting more than 28 days, and 9% for more than 42 days.

“The important message, however, is that as the pandemic has progressed and all these factors combine, survival of patients admitted to ICU with COVID-19 has significantly improved,” the researchers concluded.

Still, it’s too early for congratulations. As Cook’s group noted, even at around 42% the death rate for COVID-19 patients in the ICU is still nearly double the death rate of ICU patients battling other viral pneumonias (22%).

Even so, the findings suggest that “as the pandemic progresses, we may be coping better with COVID-19,” the team said.

For his part, Pena says the study “rightly concludes something that we expect: As we learned more about this virus and its effect on the critically ill, we became better at treating it and its complications.”

Dr. Syed Iqbal is an ICU physician at Long Island Jewish Forest Hills in New York City, which was hit hard by COVID-19 early in the pandemic. Reading over the study findings, he agreed that “the disease does have a prolonged course and some patients died after a prolonged ICU stay. It also shows that the death rate is much higher than other viral illnesses.”

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References


SOURCES: Eric Cioe Pena, M.D., director, Global Health, Northwell Health, New Hyde Park, N.Y.; Syed Iqbal, M.D., intensivist, Long Island Jewish Forest Hills, New York City; Anaesthesia, news release, July 15, 2020

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