Wednesday 29th April 2020
COVID Figures for 27th April
UK Hospital Deaths 586 / Total 21,678
James Cook Hospital – Total deaths – 178
A second day at home with the family. We have had a quiet day and we have spent the afternoon supervising the kids baking. Millionaire’s shortbread and chocolate fudge cake are on the desert menu later. However, the chocolate fudge cake was baked by my son, Jamie and having observed him making it, I reckon the millionaire’s shortbread is the better bet.
The fourth report from the Intensive Care National Audit & Research Centre (ICNARC) came out a few days ago. They report data on COVID patients that have been admitted to Critical Care Units throughout the UK. As time goes on these reports are becoming increasingly more accurate as the number of patients included increases.
This report deals with 8764 patients admitted to Critical Care Units with confirmed COVID-19 up until 24th April 2020. Of these, they have complete data on 6720 patients. The outcome of 4078 patients is known and the other 2642 remain within ICU, still being treated.
Not much has changed regarding the geography. London and the south and east of the country have still seen the most Critical Care admissions. Birmingham and the Black Country are next, with Greater Manchester, Cheshire & Merseyside and the North of England Network (our area, north of Leeds) having similar numbers of patients.
The report continues to show that the median age of those admitted is 60 years and that 72% of these patients are men. The patients had, on average spent 2-3 days on the wards before worsening to the point where they needed Critical Care.
73% of people admitted were overweight. To put this in perspective 62% of the general population is normally overweight. 8.7% of all patients admitted to Critical Care had what can be described as a ‘very severe’ underlying illness. 67% of patients needed intubation and ventilation within the first 24 hours of arrival in Critical Care. This is a high number and represents how sick the COVID patients are.
Critical Care mortality rates do not appear to have changed since the last report. Of the 4078 patients whose outcome is known, 51% have died and 49% have survived to leave ICU alive. The survivors have been treated for an average of 6 days. Of these 4078 patients who were admitted to Critical Care Units, 68% of them required a ventilator and 22% have required dialysis for kidney failure.
Of the patients whose outcome is known, 78% of under 40’s have survived to leave ICU, 73% of those in their 40’s, 57% of those in their 50’s, 42% of those in their 60’s, 32% of those in their 70’s and 31% of those in their 80’s.
Of all patients who avoided being ventilated and were given high-flow oxygen or CPAP, 82% survived. Of all the ventilated patients, 35% survived overall.
The patients who had kidney failure had the worst outcomes, overall only 22% of them survived. If they had multiple organ failure (a combination of respiratory failure requiring a ventilator, kidney failure requiring dialysis and heart failure) then only 13% survived.
But what of the patients who don’t end up in Critical Care? A large study of 17,000 patients in the UK has shown that the overall mortality rate for all patients admitted to hospital with COVID-19 is 33%. Clearly the younger patients will do better but this is an important figure. People do need to realise how serious this disease is for the small number of people who end up in hospital.
My apologies – as important as these figures are, I’ve realised that I’ve not exactly finished on a high note. Maybe I should have ended with the millionaire’s shortbread. Heck, even Jamie’s chocolate fudge cake would have done…