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| DATE | 2020-05-14 |
| FROM | Ruben Safir
|
| SUBJECT | Subject: [Hangout - NYLXS] 9 of 10 on vents don't make it
|
https://www.bloomberg.com/news/articles/2020-04-22/almost-9-in-10-covid-19-patients-on-ventilators-died-in-study
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Prognosis
New Study Shows Nearly 9 in 10 Covid-19 Patients on Ventilators Don’t
Make It
By Robert Langreth
April 22, 2020, 2:42 PM EDT Corrected April 22, 2020, 3:00 PM EDT
Researchers tracked 2,634 outcomes in NY-area hospitals
Only 3% of those over 65 on ventilators survived, report says
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A giant study that examined outcomes for more than 2,600 patients found
an extraordinarily high 88% death rate among Covid-19 patients in the
New York City area who had to be placed on mechanical devices to help
them breathe.
The study, published in the Journal of the American Medical Association,
is one of the largest reviews published to date of Covid-19 patients
hospitalized in the U.S. The researchers examined outcomes for
coronavirus patients who were admitted between March 1 and April 4 to 12
hospitals in New York City and Long Island that are part of the
Northwell Health system.
Overall, the researchers reported that 553 patients died, or 21%. But
among the 12% of very sick patients that needed ventilators to breathe,
the death rate rose to 88%. The rate was particularly awful for patients
over 65 who were placed on a machine, with just 3% of those patients
surviving, according to the results. Men had a higher mortality rate
than women.
Two days after releasing the study, the Journal issued a clarification,
deleting the 88% figure from the abstract and saying that most
ventilator patients in the study were still hospitalized and that the
mortality rate is expected to come down as more results come in. The
clarification also stated that 24.5% of the total number of patients who
had received ventilator treatment had died, while 3.3% survived and were
discharged. The rest, or 72.2%, remained hospitalized as of April 4.

“The findings of high mortality rates among ventilated patients are
similar to smaller case series reports of critically ill patients in the
US,” the authors wrote in the paper.

With no proven drugs, ventilators are one of the go-to options for ICUs
and critical care doctors in working with severe cases of Covid-19
pneumonia. But there are growing reports that few patients who get on
the machines are able to get off. As a result, some doctors are
questioning their use in Covid-19 patients and have been trying to find
methods for keeping coronavirus patients off them when possible.

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The mortality rate in the study may not represent the ultimate picture
that emerges. That’s because the study only included patients for whom a
definite outcome is known-- those who died or were discharged. It didn’t
include patients still being treated at hospitals. Outcome data were
available for just 2,634 of 5,700 patients admitted during the study period.
Northwell Health researchers involved in the study said they were aware
of the debate over when to use mechanical ventilation in Covid-19
patients, but noted that the observational nature of the study made it
impossible to draw any conclusions about how best to use of ventilators
in coronavirus patients.
“We are only reporting observations in this report,” said Karina
Davidson, senior vice president for research at Northwell Health. “So we
can’t say if mechanical ventilation had been withheld from these
patients there would have been a different survival rate.”
(Corrects to show in 4th paragraph of story originally published on Apr.
22 that the Journal of the American Medical Association later clarified
its initial findings, noting that 24.5% of the total number of
ventilated patients had so far died while 72.2% remain in the hospital.)
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