Good coronavirus news is an increasingly rare commodity these days, but a new comprehensive meta-analysis has some positivity to share. Across North American, European, and Asian hospitals, overall ICU mortality rates for adult COVID-19 patients have dropped by a third since the beginning of the pandemic.
Now, the fatality rate among critical COVID-19 patients is still considerably higher than any other type of viral pneumonia, but these findings are certainly encouraging in the sense that they indicate humanity now has a better understanding of how to effectively combat the coronavirus.
The research, which was conducted by the University of Bristol and Royal United Hospitals Bath NHS Trust, closely examined a large collection of published data on COVID-19 ICU mortality rates between the end of March 2020 and May 2020. That analysis revealed combined mortality rates across all three studied continents dropped by roughly a third, from 60% in March to 42% in May, over that period.
Additionally, the study also noted that ICU mortality numbers have largely been quite similar in Asia, Europe, and North America.
“The important message is that as the pandemic has progressed and various factors combine, the survival of patients admitted to ICU has significantly improved. There were no significant effects of geographical location, but reported ICU mortality fell over time. Optimistically, as the pandemic progresses, we may be coping better with COVID-19,” says lead study author Professor Tim Cook, Honorary Professor in Anaesthesia at the University of Bristol and Consultant in Anaesthesia and Intensive Care Medicine at Royal United Hospitals Bath NHS Foundation Trust, in a release.
The study’s authors analyzed all research on COVID-19 adult death rates in ICU facilities published in four different research databases (MEDLINE, PubMed, EMBASE, and Cochrane) up until May 31st, 2020. During their investigation, researchers looked specifically for ICU patient outcomes. That means they focused solely on COVID-19 patients who saw their ICU stay come to an end, either via recovery and discharge or death. Patients who were still receiving ICU treatment at the time of said research were not included in the meta-analysis.
In total, 24 ICU studies encompassing 10,150 coronavirus patients were included in this project. The combined ICU mortality rate of all those studies through May 31st came out to 41.6%, but when only studies conducted through March 31st were analyzed, that mortality rate increased to 59.5%.
These are obviously uplifting findings, but Professor Cook was quick to note that COVID-19 is still taking lives at a rapid pace.
“The in-ICU mortality from COVID-19, at around 40%, remains almost twice that seen in ICU admissions with other viral pneumonias, at 22%.” Professor Cook adds.
As far as the cause of this decline, researchers have a few theories.
“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. 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 study reads.
These results may have been somewhat influenced by the length of ICU care among many COVID-19 patients. It isn’t uncommon at all for a patient to spend around a month in intensive care. So, many patients who were still fighting the virus in March may have beaten the infection and returned home by May.
This element, though, does not discredit the project’s overall findings.
“The important message, however, is that as the pandemic has progressed and all these factors combine, survival of patients admitted to ICU with COVID-19 has significantly improved,” the study’s authors write.
Also, there were no significant fluctuations in mortality rates among the three different continents. This is notable because hospitals in different areas of the world vary somewhat when it comes to their COVID-19 treatment procedures. These findings, though, support prior research that had concluded no obvious, superior coronavirus treatment option has emerged thus far.
Still, the team behind this study feel their work more than justifies a little bit of optimism.
“This systematic review and meta-analysis of ICU outcome in patients with COVID-19 found an in-ICU mortality rate of 41.6% across international studies. There were no significant effects of geographical location, but reported ICU mortality fell over time. Optimistically, as the pandemic progresses, we may be coping better with COVID-19,” the research team concludes.
The full study can be found here, published in Anaesthesia.