More than one in three coronavirus patients admitted to ICUs in the US will die within a month of being moved into critical care, a new study finds.
As cases surge in many US states – increasing most dramatically in Florida, Texas, Arizona and Oklahoma – hospitalizations are beginning to rise and the nation is holding its breath for ICU beds to fill.
New research from Brigham and Women’s Hospital suggests that where a patient ends up in critical care may have a dramatic effect on their survival odds.
People admitted to critical care at hospitals with fewer than 50 ICU beds were more than three-times more likely to die, compared to patients in hospitals that had 100 or more such beds, they found.
ICU beds are filling up in states like Mississippi, as coronavirus cases surge across the US. A new study found that more than one third of ICU patients in 65 hospitals died
For the Brigham and Women’s study, the researchers analyzed data on more than 2,000 ICU patients across 65 hospitals.
All of the patients were admitted March 4 and April 4 – what was then considered the peak of the pandemic in the US.
In total, 784 of the patients admitted to ICUs across much of the US died in under a month (28 days).
Patients who suffered from chronic diseases including kidney and liver dysfunction, obesity, heart disease, cancer, or had low oxygen levels when they were admitted were at greater risk of dying, as has been widely seen.
Also consistent with previous data, men and older patients were at greater risk of succumbing to COVID-19.
But death rates varied wildly from hospital to hospital.
In some ICUs, as few as six percent of patients died, while in others the fatality rate soared up to 80 percent.
Although the study did not establish what kinds of treatments might work best, the authors did find wide variations in the methods chosen from hospital to hospital.
At that time, hydroxychloroquine was certainly controversial, but still regarded optimistically by many doctors throughout the country.
Nearly 80 percent of patients were given the malaria drug, and nearly 60 percent were given the antibiotic azithromycin, which was used in combination with hydroxychloroquine to treat 50 percent of patients.
Only 6.1 percent of patients got remdesivir – now shown to reduce the severity of coronavirus and risk of death – and 3.8 percent were given a combination of HIV drugs now believed ineffective against the disease.
In total, 38 percent of the patients were put in prone position in an effort to help them breathe more easily, but the use of that method varied drastically from hospital to hospital.
At one hospital, only four percent of patients were put onto their stomachs, while 80 percent of critically ill people were flipped over at another.
But the most significant difference in death rates came down to the hospital itself – specifically, how many ICU beds the facility had to begin with.
Critically ill patients admitted to hospitals with 50 or fewer ICU beds had a 3-fold lower chance of survival than did patients who got care at larger facilities with 100 or fewer beds.
It’s not exactly clear why patients at these smaller hospitals faced so much poorer odds, but these facilities may have lacked personnel or resources to and been more strained than others.
Coronavirus is still hitting cities hardest – now striking metropolitan areas like Miami-Dade County in Florida, Houston, Texas and Phoenix, Arizona – but it’s beginning to overwhelm less populated areas as well.
As of Thursday, one third of Florida counties have fewer than 10 ICU beds left.
Fewer than 10 percent of all hospitals in the state have more than 50 hospitals, and if the trends observed by the Brigham and Women’s team hold true, it could bode poorly for the soaring number of coronavirus patients in Florida.