According to a new paper published on Wednesday in the journal Anaesthesia, fewer patients admitted into intensive care due to COVID-19 are dying. This report comes after reviewing and analyzing more than 10,000 cases from two dozen studies around the universe. The report revealed that the death rate for adult COVID patients in ICU reduced over time, to 41.6 percent from above 50 percent. However, succumbing to COVID while in ICU was still almost double that of patients admitted into ICU for other viral pneumonia.
According to the study, even though factors like admission criteria, treatments delivered, and the thresholds for the treatments were different across the studies, the ICU mortality numbers did not change significantly around the globe. The paper concluded that the reported ICU mortality fell over time as countries in the later phase of the pandemic may be coping better with COVID-19. The study indicated that a patient’s age, comorbidities, together with ethnicity, were likely to have a “significant influence” on mortality.
The study focused on the ICU outcomes for 10,150 patients who were admitted with a COVID-19 diagnosis from France, Canada, Denmark, the Netherlands, China, the United States, Hong Kong, Italy, Singapore, Spain and the U.K. The research observed the number of ICU deaths as a proportion of “completed” ICU admissions. However, those still alive in ICU were excluded.
According to the researchers, the paper did not explore the impact of treatments as the details vary from study to study. What did not demonstrate any significant differences in the analysis by geographical location, sample size, and patient characteristics like age?
Research published in CMAJ at the end of June in Canada also explored critically ill patients admitted to ICU for COVID-19 in Metro Vancouver between Feb. 21 and April 14, 2020. The mortality was found to be lower than what other studies had published. The B.C. research found that among the ICU patients it assessed, 15.4 percent died, 60.7 percent were discharged home, 10.3 percent remained in the ICU, 13.7 percent were discharged from the ICU, but remained hospitalized.
LIMITATIONS OF STUDY
A high degree of heterogeneity was one of the limitations of the study. This means that there was a lot of variability in the data from the study to the study. The paper said that the definition of ‘intensive care’ is unlikely to be consistent in all studies as admission criteria and intensive care provision likely differ across global healthcare systems. Non-invasive ventilation was reported in Asia. The authors also said that this is consistent with research findings to date, suggesting that no specific therapy reduces ICU mortality. What also varied greatly is the survival rates between studies.
The researchers said that further analyses did not result in significant differences, despite the variations in the studies. Moreover, they reported that it was important to have more consistency in the data collected. They also reported that it was also worth exploring further the longer-term outcomes of the patients discharged from ICU. Prof. Tim Cook, a consultant in Anaesthesia and Intensive Care Medicine, led the systematic review and meta-analysis.