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>Covid-19 Live Updates: Survival Rates Increase, and Not Just Because of Younger Patients
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>In Europe, where countries are contending with a new wave of infections, unemployed young people face an especially tough path. And in the United States, the pandemic has been linked to an increase in violence.
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>In April, the coronavirus killed more than 10,000 people in New York City. By early May, nearly 50,000 nursing home residents and their caregivers across the United States had died.
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>But as the virus continued its rampage over the summer and fall, infecting nearly 8.5 million Americans, survival rates, even for seriously ill patients, appeared to be improving. At a New York hospital system where 30 percent of coronavirus patients died in March, the death rate had dropped to 3 percent by the end of June.
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>Doctors in England observed a similar trend. “In late March, four in 10 people in intensive care were dying.” said John M. Dennis, a University of Exeter Medical School researcher. “By the end of June, survival was over 80 percent.”
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>Though the virus has been changing slowly as it spreads, most scientists say there is no solid evidence that it has become either less virulent or more virulent.
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>As older people took greater precautions to avoid infection, however, more of the hospitalized patients were younger adults, who are generally healthier and more resilient. By the end of August, the average patient was under 40.
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>Were the lower death rates simply a function of the demographic changes, or a reflection of advances in treatment that blunted the impact of the new pathogen?
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>Researchers at NYU Langone Health zeroed in on this question, analyzing the outcomes of more than 5,000 patients hospitalized at the system’s three hospitals from March through August. They concluded the improvement was real, not just the result of a younger patient pool.
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>Even when they controlled for differences in the patients’ age, sex, race, underlying health problems and severity of Covid symptoms — like blood-oxygen levels at admission — they found that death rates had dropped significantly, to 7.6 percent in August from 25.6 percent in March.
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>A combination of factors contributed to the improved outcomes of hospital patients, experts said. As clinicians gained more experience with the disease, they became better able to manage it, incorporating the use of steroid drugs and non-drug interventions.
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>Researchers have also credited heightened community awareness. Patients are seeking care earlier in the course of their illness. And outcomes may also have improved as the load on hospitals lightened and there was less pressure on the medical staff.
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>“We don’t have a magic bullet cure, but we have a lot, a lot of little things, that add up,” said Dr. Leora Horwitz, director of NYU Langone’s Center for Healthcare Innovation & Delivery Science. “We understand better when people need to be on ventilators and when they don’t, and what complications to watch for, like blood clots and kidney failure.”
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>Once doctors became aware of the clotting risk, they began to quickly put patients on blood thinners when necessary.
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>Another problem in the spring was that as hospitals in hard-hit areas like New York City became overwhelmed, doctors who hadn’t worked in critical care for many years were being drafted to care for seriously ill patients. Nursing departments, meanwhile, were short-staffed, and equipment was in short supply.
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>Medical experts worry that the surges in cases around the country could roll back the improvements in mortality rates. The number of hospitalized Covid patients has increased by 40 percent over the last month, and more than 41,000 patients are now hospitalized in the United States.
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>— Roni Caryn Rabin