Study: Most Critically Ill Patients With COVID-19 Survive With Standard Treatment

According to a new study published in the American Journal of Respiratory and Critical Care Medicine, even the sickest patients with coronavirus disease 2019 (COVID-19) who require ventilators in intensive care units (ICUs) improve when given treatment that follows existing guidelines for respiratory failure.¹

The study was authored by 2 physicians based in Boston from Massachusetts General Hospital (Mass General) and Beth Israel Deaconess Medical Center.¹

Although hospitals around the world are currently treating patients with COVID-19, until the release of this study, physicians were only able to share anecdotal evidence to inform care for patients infected with the coronavirus due to the lack of studies available.¹

In order to provide more reliable information, the research team examined the records of 66 critically ill patients with COVID-19 who experienced respiratory failure and were placed on ventilators.¹

The results demonstrated that the most severe cases of COVID-19 caused acute respiratory distress syndrome (ARDS), which is a life-threatening lung condition that can be caused by a range of different pathogens.¹

“The good news is we have been studying ARDS for over 50 years and we have a number of effective evidenced-based therapies with which to treat it,” said C. Corey Hardin, MD, PhD, co-author of the study and assistant professor of medicine at Mass General and Harvard Medical School, in a press release. “We applied these treatments—such as prone ventilation where patients are turned onto their stomachs—to patients in our study and they responded to them as we would expect patients with ARDS to respond.”²

For those critically ill patients with COVID-19 given evidence-based ARDS treatments, the death rate was 16.7%, which is much lower than the rate reported by other hospitals. After looking at 3 other statistical analyses of death rates of patients with COVID-19 in ICUs, the physicians found that 5% to 20% of patients with COVID-19 are admitted to the ICU, with mortality reported between 26% and 61.5%.¹

Furthermore, the physicians noted that the median follow-up for patients on evidence-based ARDS treatments was 34 days, with 75.8% of patients who were on ventilators being discharged from the ICU.¹

“Based on this, we recommend that clinicians provide evidence-based ARDS treatments to patients with respiratory failure due to COVID-19 and await standardized clinical trials before contemplating novel therapies,” said Jehan Alladina, MD, co—author of the study and instructor in medicine at Mass General, in a press release.²

REFERENCES

• Ziehr DR, Alladina J, Petri CR, et al. Respiratory Pathophysiology of Mechanically Ventilated Patients with COVID-19: A Cohort Study. American Journal of Respiratory and Critical Care Medicine. 2020. doi: 10.1164/rccm.202004-1163LE. Accessed May 7, 2020.
• Study Reveals Most Critically Ill Patients with COVID-19 Survive with Standard Treatment [news release]. Boston, MA: Massachusetts General Hospital; May 6, 2020. massgeneral.org/news/coronavirus/study-reveals-critically-ill-patients-with-covid-19-survive-with-standard-treatment. Accessed May 7, 2020.