Nearly 25 Percent of Coronavirus Patients Put on Ventilators in New York's Largest Health System Died, Study Shows

Nearly 25 percent of coronavirus patients placed on ventilators between March 1 and April 4 at hospitals within Northwell Health, New York's largest health system, were reported to have died, according to a new study published in the Journal of the American Medical Association (JAMA).

The study, conducted by researchers at the Northwell Health COVID-19 Research Consortium and the Feinstein Institutes for Medical Research, observed 5,700 COVID-19 patients admitted to 12 hospitals within Northwell Health between March 1 and April 4.

The latest study is believed to be "the first large case series of sequentially hospitalized patients with confirmed COVID-19 in the U.S.," the report said. Northwell Health serves nearly 11 million people across New York City, Long Island and Westchester County.

Speaking to Newsweek, Karina W. Davidson, senior vice president at the Feinstein Institutes for Medical Research, who are affiliated with the study, said: "Understanding COVID-19's impact on our community is needed to manage the infection effectively, and to provide insights into later prevention, treatments and cures. Our research was able to look at 5,700 Northwell patients who received hospital care across our health system – and for the first time that large population shed some light on the clinical characteristics of those with a severe infection."

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The study noted that for patients requiring mechanical ventilation (1,151 patients), 24.5 percent (282) died, while 38 were discharged alive and 831 patients remained in hospital.

Among those who were on ventilators, the mortality rate of those aged over 65 was 97.2 percent and 76.4 percent for those aged between 18 and 65, the report shows.

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There were 3,066 patients who remained hospitalized by the end of the study. "The absence of data on patients who remained hospitalized at the final study date may have biased the findings, including the high mortality rate of patients who received mechanical ventilation older than age 65 years," the study notes.

Of the 2,634 patients who were either discharged or died by the end of the study, "14.2 percent were treated in the intensive care unit (ICU), 12.2 percent received invasive mechanical ventilation, 3.2 percent were treated with kidney replacement therapy, and 21 percent died," the study notes.

Nearly two percent of patients were readmitted during the study period. For patients who were discharged, the readmission rates and the percentage of patients discharged to a facility (such as a nursing home or rehabilitation), instead of their home, increased in the older age groups.

The majority of patients in the study were reported to be male and the median age of all patients was 63. The mortality rates were recorded to be higher for male patients than female patients at every adult 10-year age interval.

Coronavirus, New York City, April 2020
A health care worker outside Elmhurst Hospital Center during the COVID-19 pandemic on April 20, 2020 in New York City. Getty Images

A third of all patients (1,734) were reported to have a fever, 986 had a high respiratory rate and 1,584 patients received supplemental oxygen. Patients were reported to have been discharged after around four days, on average.

"Mortality rates for those in the 18-to-65 and older-than-65 age groups who did not receive mechanical ventilation were 19.8 percent and 26.6 percent, respectively. There were no deaths in the younger-than-18 age group," the report said.

Of the patients who were discharged or had died, 16.6 percent were younger than 50 years old. For both patients who were discharged and those who died, the percentage of patients who were treated in the ICU or placed on a ventilator was higher in the 18-to-65 age group compared with the older-than-65 years age group, the study showed.

The most common co-morbidities among the patients in the study were reported to be hypertension (about 56 percent of patients), obesity (42 percent), and diabetes (34 percent).

"Of the patients who died, those with diabetes were more likely to have received invasive mechanical ventilation or care in the ICU compared with those who did not have diabetes.

"Of the patients who died, those with hypertension were less likely to have received invasive mechanical ventilation or care in the ICU compared with those without hypertension. The percentage of patients who developed acute kidney injury was increased in the subgroups with diabetes compared with subgroups without those conditions," the study explains.

Around 98 percent of the patients in the study tested positive for the virus on the first test, while 1.9 percent tested negative at first and positive on a repeat test. The rate of co-infection with another respiratory virus for those tested was 2.1 percent, the study showed.

"Dr. Davidson and the Northwell Consortium research team provide a crucial early insight into the front line response to the COVID-19 outbreak in New York," said Kevin J. Tracey, MD, president and chief executive officer of the Feinstein Institutes for Medical Research. "These observational studies and other randomized clinical trial results from the Feinstein Institutes will improve the care for others confronting COVID outbreaks."

New York, the country's worst-hit state, has reported at more than 262,200 confirmed cases, as of Thursday. The state has recently shown signs of the outbreak slowing down, with the number of new cases continuing mostly on a decline.

On Sunday, single-day hospitalization, intubation and fatality counts were reported to have decreased statewide from the previous day. The number of new cases in the state fell for six consecutive days between April 14 and April 20, according to figures from the New York State Department of Health.

"We are at a profound moment in this crisis where we are finally passing the apex of the curve, but if we make a bad move now it's going to set us back," New York Governor Andrew Cuomo said at a press conference on Wednesday. "We're beginning to make plans on how to re-open our economy and start the return to the new normal, but in the meantime we have to ensure our health care system and our hospitals that have been so critical in combating this virus have the support they need."

The novel coronavirus, which was first reported in Wuhan, China, has infected more than 2.6 million people, including more than 843,900 in the U.S., according to the latest figures from Johns Hopkins University. The graphic below, provided by Statista, illustrates the spread of COVID-19 across the U.S.

Statista
This infographic shows the number of confirmed COVID-19 cases around the U.S. as of April 23. Statista

Data on COVID-19 cases is from Johns Hopkins University unless otherwise stated.

Centers for Disease Control and Prevention Advice on Using Face Coverings to Slow Spread of COVID-19

  • CDC recommends wearing a cloth face covering in public where social distancing measures are difficult to maintain.
  • A simple cloth face covering can help slow the spread of the virus by those infected and by those who do not exhibit symptoms.
  • Cloth face coverings can be fashioned from household items. Guides are offered by the CDC. (https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html)
  • Cloth face coverings should be washed regularly. A washing machine will suffice.
  • Practice safe removal of face coverings by not touching eyes, nose, and mouth, and wash hands immediately after removing the covering.

World Health Organization advice for avoiding spread of coronavirus disease (COVID-19)

Hygiene advice

  • Clean hands frequently with soap and water, or alcohol-based hand rub.
  • Wash hands after coughing or sneezing; when caring for the sick; before, during and after food preparation; before eating; after using the toilet; when hands are visibly dirty; and after handling animals or waste.
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  • Avoid touching your hands, nose and mouth. Do not spit in public.
  • Cover your mouth and nose with a tissue or bent elbow when coughing or sneezing. Discard the tissue immediately and clean your hands.

Medical advice

  • Avoid close contact with others if you have any symptoms.
  • Stay at home if you feel unwell, even with mild symptoms such as headache and runny nose, to avoid potential spread of the disease to medical facilities and other people.
  • If you develop serious symptoms (fever, cough, difficulty breathing) seek medical care early and contact local health authorities in advance.
  • Note any recent contact with others and travel details to provide to authorities who can trace and prevent spread of the disease.
  • Stay up to date on COVID-19 developments issued by health authorities and follow their guidance.

Mask and glove usage

  • Healthy individuals only need to wear a mask if taking care of a sick person.
  • Wear a mask if you are coughing or sneezing.
  • Masks are effective when used in combination with frequent hand cleaning.
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  • Learn how to properly put on, remove and dispose of masks. Clean hands after disposing of the mask.
  • Do not reuse single-use masks.
  • Regularly washing bare hands is more effective against catching COVID-19 than wearing rubber gloves.
  • The COVID-19 virus can still be picked up on rubber gloves and transmitted by touching your face.

Correction: The headline and original story originally stated that nearly 90 percent of COVID-19 patients on ventilators at Northwell Health had died. The Journal of the American Medical Association has since issued a clarification, saying that only 24.5 percent of ventilator patients in the study had died, while the rest were still hospitalized. The headline and story has been changed accordingly.

Nearly 25 Percent of Coronavirus Patients Put on Ventilators in New York's Largest Health System Died, Study Shows | News