The Survival Rates for COVID patients ending up on ventilators

April 5, 2020

We have analysed a few studies and have attached the document below. 

Overall the results were difficult to interpret overall. The numbers are small and results are incomplete as they did not include patients who are still in ICU.  Furthermore not all those in ICU received mechanical ventilation.

 China study studies are not that informative.  The UK may be the closest to the true picture (about 50% survival) but they are still early findings.    

We have made the following comments below:

  • Hospitals should prioritise patients with the best chance of survival as coronavirus overwhelms the health service, even where families disagree.  This is Medical Council advice to doctors in Ireland: “In making decisions based on the principle of prioritising the use of scarce resources to treat those patients most likely to survive, more lives are likely to be preserved,” it has said.  This appraisal of the potential benefits a treatment might provide to different patient “lies within the scope of experienced intensive care medicine doctors”.  However, “patients, families or allied may sometime hold different views”.  Allocation of “finite” healthcare resources in a way that is equitable and just “will present difficult choices”. “Doctors have a duty to use resources prudently and fairly, to produce the most benefits possible for individuals served by those interventions.”  This applies particularly to intensive care.
  • Survival rates of those admitted to intensive care will be in worse in hospitals which do not normally provide this service.  Use of current or additional ventilators depends on having skilled staff who are trained to use them.  It follows that survival in LICs is likely to be much lower than HICs.
  • Patients may remain on ventilators for many days and this reduces availability for others.  This is another reason only to put those on ventilators who are likely to survive.
  • A more fundamental decision is not to admit those to hospital in the first place if they are unlikely to benefit.  This can help avoid a difficult decision on whether to ventilate after admission.

Resources:

https://globalhealth.ie/wp-content/uploads/2020/04/ICNARC-COVID-19-report-2020-03-27.pdf

https://globalhealth.ie/wp-content/uploads/2020/04/Clinical-course-and-risk-factors-for-mortality-of-adult-with-COVID19-in-Wuhan.pdf

https://globalhealth.ie/wp-content/uploads/2020/04/Clinical-Characteristics-of-138-Hospitalized-Patients-With-2019-Novel-Coronavirus–Infected-Pneumonia-in-Wuhan.pdf

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