The team also reported that ICU mortality for COVID-19 was broadly consistent across the globe, based on medical data from Europe, Asia and North America.
ICU deaths have declined over time
In the new report, researchers scoured medical databases for studies that looked at ICU morality for adult COVID-19 patients. In particular, they searched the MEDLINE, EMBASE, PubMed and Cochrane databases for studies up to May 31, 2020. The team looked at research that used ICU deaths as a primary outcome measure in relation to completed ICU admissions, either through discharge or death. Based on their definition, they did not include outcomes that where patients were still alive in ICU.
The researchers enrolled a total of 24 observational studies in their review, which included reports from healthcare facilities across Asia, Europe and North America. The team found that combined deaths from COVID-19 patients in ICUs at the end of May was 41.6 percent. This was significantly lower than ICU mortality reported in studies up to the end of March, wherein deaths were at 59.5 percent.
“The in-ICU mortality from COVID-19, at around 40%, remains almost twice that seen in ICU admissions with other viral pneumonias, at 22%,” the authors added.
According to the authors, several factors can account for the decrease in ICU mortality over time.
“It may reflect the rapid learning that has taken place on a global scale due to the prompt publication of clinical reports early in the pandemic,” they explained. “It may also be that ICU admission criteria have changed over time, for example, with greater pressure on ICUs early in the pandemic surge.”
The researchers also noted that their findings might not take into consideration the lag time caused by prolonged ICU stays. The time for an intubated patient to be weaned from a ventilator, for instance, takes time to appear in the data.
In the U.K., severe COVID-19 symptoms can last for long periods in the ICU, with 20 percent lasting nearly a month and nine percent lasting over 42 days. Despite these figures, the researchers stressed their findings meant that the survival of COVID-19 patients admitted to ICUs has “significantly improved.”
In their report, they also said that ICU mortality is consistent in many regions around the world, even after adjusting for admission, treatments delivered, and application threshold. However, this also indicated the lack of conventional treatments for reducing ICU mortality. Currently, there are no treatments for COVID-19 approved by the Food and Drug Administration. Remdesivir, the controversial drug touted to reduce hospital time in severe COVID-19 patients, is only allowed for emergency use. (Related: US government to send remdesivir to coronavirus hotspots, depleting federal stockpile.)
Based on their review, the team concluded that ICU mortality for patients with COVID-19 has significantly improved over time, regardless of geographical location.
“Optimistically, as the pandemic progresses, we may be coping better with COVID-19.”
As of press time, there are now 13,578,608 confirmed cases of COVID-19 worldwide and 584,794 deaths, according to data from Johns Hopkins University.
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