April 5, 2020

expert reaction to updated report on patients critically ill in intensive care with COVID-19, as published on Saturday by ICNARC (Intensive Care National Audit & Research Centre)

The Intensive Care National Audit & Research Centre (ICNARC), has published an updated report on patients in intensive care who are critically ill with COVID-19.

Prof Duncan Young, Professor of Intensive Care Medicine, University of Oxford, said:

“By midday on the 3rd April ICNARC had recorded 2621 admissions of patients with COVID-19 infections to ICUs in England, Wales and Norther Ireland.  The majority are still being treated in an ICU.

“As in the previous report the patients are predominantly male (73%), with an average age of 60.  The largest number of cases are still in London, Thames Valley and South-east regions.

“We only know the outcome (alive/dead) for a small proportion of those admitted to an ICU, so we can’t necessarily generalise these findings to what might happen to those admitted to an ICU in the future.

“The number of patients who have left ICU has increased quite considerably since the last report.  Data are available on 690 discharges.  Of these half were discharged alive and half died on the ICU.  Data are available on a smaller number of discharged patients (388) who had required treatment with a ventilator (artificial ventilation).  Only a third of these patients survived to leave an ICU.  ICNARC supplies comparator data for non-COVID-19 viral pneumonia where the mortality of patients treated in an ICU was 22%.  In general patients with the acute respiratory distress syndrome (ARDS), which causes a similar deterioration in lung function requiring artificial ventilation, have less than 20% mortality.

“The relative ineffectiveness of artificial ventilation might suggest that COVID-19 causes a particularly treatment-resistant form of pneumonitis.  It is also possible that in some patients COVID-19 is causing multi-organ failure of which the respiratory failure is the presenting problem but may not always be the cause of death – but there are no data on this yet.

“The majority of the cases reported here are still being treated in ICUs, and the ICNARC report contains appropriate cautions on interpreting outcome and treatment data.  ICNARC only looks at patients who become critically ill with COVID-19, not those many others who have mild symptoms managed at home.”

https://www.icnarc.org/About/Latest-News/2020/04/04/Report-On-2249-Patients-Critically-Ill-With-Covid-19

All our previous output on this subject can be seen at this weblink:

www.sciencemediacentre.org/tag/covid-19

Declared interests

None received.