Long Hospital Stays, High Rates of ICU Admission for US COVID-19 Patientshttps://medicalxpress.com/news/2020-05-hospital-high-icu-admission-covid-.htmlHospitalized COVID-19 patients in the U.S. are enduring longer hospital stays and facing higher rates of intensive care unit (ICU) admission than patients in China, finds a new study led by researchers at the University of California, Berkeley, and Kaiser Permanente.
The results suggest that hospitals in the U.S. may be harder hit by the coronavirus pandemic than initially thought, as many forecasts of disease burden—particularly the number of hospital beds and ICU units needed at the peak of infection—are based on data out of China.
The study focused on 1,277 Kaiser Permanente members who were hospitalized with clinically- or laboratory-confirmed cases of COVID-19 between the start of the year and early April.
"Because Kaiser Permanente members receive comprehensive health care from a single provider network, we overcome many of the difficulties that arise in studies of diseases within the fragmented U.S. health care delivery system," said Lewnard.
Of the 1,277 Kaiser Permanente members who were hospitalized with COVID-19, 42% required care in the ICU, and 18% died from the disease. Modeling estimates based on observations in China usually assume that only about 30% of hospitalized patients will require ICU care.Similarly, the data showed that hospital stays lasted an average of 10.7 days for survivors and 13.7 days for non-survivors, compared to an average of 7.5 days among non-survivors in China.
Troublingly, 25% of patients were hospitalized for 16 days or more. In comparison, a widely-used modeling study from Imperial College London projecting health care needs assumes an average stay of eight days.Not surprisingly, the analysis also revealed that the virus tends to hit older people the hardest. Approximately 50% of hospitalizations were among adults aged 60 and older, and 25% were among adults aged 73 and older. Similarly, hospitalized men seemed to be hit harder than women: Hospitalized males over the age of 80 faced a 58% risk of death, and hospitalized females of the same age faced only a 32% risk of death.
However, while the data indicate that social distancing is succeeding, the authors warn that we shouldn't expect to return to normal anytime soon.
... "These data suggest that if we were to release all of our mitigation measures at one time, the disease would start rapidly spreading again," Liu said. "We have to be really strategic and vigilant about how and when we roll back our social distancing measures.
"We also need to be mindful of just how severe the disease is," Lewnard added. "We see an 18% overall fatality rate among all people who are getting hospitalized, and 42% end up in the ICU, so the impact of transmission in terms of severe disease and hospital burden is quite high." ...
Open Access: Joseph A Lewnard et al,
Incidence, clinical outcomes, and transmission dynamics of severe coronavirus disease 2019 in California and Washington: prospective cohort study, BMJ (2020)
https://www.bmj.com/content/369/bmj.m1923 --------------------------------
Northern England Hit Harder By COVID-19 and Effects Will Last Longerhttps://medicalxpress.com/news/2020-05-northern-england-harder-covid-effects.htmlAnalysis released today by the Northern Health Science Alliance, in collaboration with the NIHR Applied Research Collaborations (ARCs) in the North East & North Cumbria and Greater Manchester, show the impacts of the virus are already hitting hard; on death rates from the illness, death rates from all causes and on job losses.
The team analysed data from the Office for National Statistics to map figures for the last six weeks on COVID19 deaths, deaths from all causes, and unemployment figures, to build up a picture of how the virus is affecting different parts of England.
The figures show deprived urban areas in the North of England are being hit with high rates of COVID deaths, higher death rates from all causes and particularly suffering from greater rates of increases in unemployment.
Researchers looked at the average England COVID mortality rate (36.6 per 100,000 people) and the average all-cause mortality rate (161 per 100,000 people) from March 1 to April 17 and the average increase in rate of people claiming unemployment benefits (1.9 percentage points) from March 12 to April 9. They then mapped across the main trainlines in England to see how different urban and rural centres performed compared to the national average in all three metrics.
Main centres in the North including Manchester, Liverpool, Newcastle and Durham are above the English average in all three areas whereas Slough is the only place outside of the North to be red in all areas.
Dr. Luke Munford of the University of Manchester said: "This visualisation shows that COVID-19 is impacting parts of the country in different ways, and there appears to be a North/South divide emerging.
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