Intensive care medicine

Overall COVID-19 ICU Mortality Rates Have Decreased By Nearly One Third

Overall COVID-19–related mortality among patients in intensive care units (ICUs) has decreased by nearly one-third since the end of March 2020, according to the results of a recent analysis.1

In order to estimate mortality rates among patients with COVID-19 admitted to the ICU, as well as to examine how factors such as geography and phases of the pandemic affected these rates, the researchers performed a systematic review and meta-analysis using data from 24 observational studies (N=10,150 patients) conducted from December 19, 2019, to May 28, 2020, in Asia, Europe, and North America.

Seven of the studies reported outcomes for 100% of participants, while in the other 17 studies, the number of patients discharged from the ICU at the time of reporting varied from 24.5% to 97.2%. Patients who were still in the ICU at the time of reporting were excluded from the analysis. Reported mortality rates varied from 0.0% to 84.6%.

Overall, pooled ICU mortality across all of the studies was 41.6%. This represents a decrease of roughly one-third since March 2020 (59.5%) and is significantly lower than some estimates reported at the beginning of the pandemic, “which exceeded 90% for patients undergoing invasive ventilation, and led to fears that patients requiring intensive care had an unacceptably high rate of death,” the researchers wrote. However, it is still approximately twice that seen with other viral pneumonias (22%).

“The important message is that as the pandemic has progressed and various factors combine, survival of patients admitted to ICU has significantly improved … Optimistically, as the pandemic progresses, we may be coping better with COVID-19,” the authors said in an accompanying press release.2

“In the future, it is important that such outcome data are collected and reported in a more systematic manner, supplemented by clear definitions of ‘intensive care’ and including the admission criteria applied, patient status on admission and treatments delivered while in ICU.”

—Michael Potts

References:

  1. Armstrong RA, Kane AD, Cook TM. Outcomes from intensive care in patients with COVID‐19: a systematic review and meta‐analysis of observational studies. Anaestesia. Published online June 30, 2020. doi:10.1111/anae.15201
  2. Overall COVID-19 intensive care mortality has fallen by a third. News release. University of Bristol; July 15, 2020. Accessed July 21, 2020. http://www.bristol.ac.uk/news/2020/july/covid-19-icu-mortality.html