Audit highlights how COVID-19 in critical care differs from usual viral pneumonia cases

Emerging data from critical care units in the UK has provided details on the groups most at risk of severe disease from COVID-19, how it compares to pre-pandemic viral pneumonia and how those on the front line are managing patients.

Information on the first 775 patients collected by the Intensive Care National Audit and Research Centre confirms reports from other countries that men dramatically outnumber women among COVID-19 patients in critical care.

It also shows that age is a key factor but that younger patients with no significant mortality can get severe illness.

Up to the 26th March, 79 of the patients included in the audit data had died and 86 had been discharged from critical care. Around half the 775 patients were being looked after by teams in London.

A far higher percentage of patients were mechanically ventilated (78.7%) than patients with viral pneumonia treated in critical care (43.2%) over the past two years prior to the coronavirus pandemic, the data showed

In all 70% of patients admitted to critical care were male, compared with 54% for non-COVID viral pneumonia since 2017. Men were also more likely to die making up 58 of the 79 deaths.

Only one of the 228 women being treated by participating critical care units was currently pregnant, the ICNARC reported.

The audit also shows that most critically ill COVID-19 patients were independent having not previously needed assistance with daily activities. Around 9% needed some assistance.

Among the very severe co-morbidities noted were respiratory disease in 1% of patients and 3% of patients who were immunocompromised.

As expected from what has been seen in China and Italy, age is a factor in recorded outcomes from COVID-19, the report shows.

Among 16-to-49 year olds in the dataset there had been 9 deaths, compared with 29 in 50-to-69 year olds and 41 in those over the age of 70 years.

The ICNARC data which is collected from 285 critical care units is updated on a weekly basis.

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