Canadian study of critically ill patients with COVID-19 found lower death rate

A Canadian case series of all patients with COVID-19 admitted to six intensive care units (ICUs) in Metro Vancouver found patient outcomes were substantially better than reported in other jurisdictions. The paper is published in CMAJ (Canadian Medical Association Journal).

Researchers looked at outcomes for 117 patients with COVID-19 admitted to one of six hospitals in Metro Vancouver between February 21 and April 14, 2020. Patients ranged in age from 23 to 92 years, with a median age of 69 years. Two-thirds (67.5%) were male. As of May 5, 85% of patients were still alive and 61% had been discharged home. The overall mortality rate was 15%.

"The overall mortality was appreciably lower than in previously published studies, despite comparable baseline patient characteristics and a higher proportion of patients with completed hospital courses," writes Dr. Donald Griesdale, a critical care physician at Vancouver General Hospital and associate professor at the University of British Columbia's Faculty of Medicine, Vancouver, BC, with coauthors.

Data from Lombardy, Italy, showed a 61% mortality rate for patients admitted to an ICU, a case study of 24 people in Seattle had a 57% mortality rate among patients in the ICU, and a case series from Wuhan, China, reported a mortality rate of 80% in patients admitted to the ICU.

Fewer patients in the Canadian series (63%) received mechanical ventilation than in Lombardy (88%), Seattle (75%) and New York (90%), but in Wuhan even fewer (42%) received mechanical ventilation. Very few patients received unproven treatments for COVID-19; one patient received hydroxychloroquine, four received tocilizumab, and none recived remdesivir.

"Despite the observed differences between patients and critical care interventions in these studies, it is unclear whether these solely account for the marked lower mortality that we report," write the researchers. "We hypothesize that these encouraging results may be due to a broader system-level response that prevented an overwhelming surge of critically ill patients with COVID-19 from presenting to our hospitals and ICUs."