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.
“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.
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.”