COVID-19 patients treated in busy ICUs at higher risk for death, study finds

Jan. 19 (UPI) -- COVID-19 patients treated in hospital intensive care units during periods of increased demand are nearly twice as likely to die from the disease compared to those who receive care during low-demand periods, a study published Tuesday by JAMA Network Open said.

Those who receive care in intensive care units operating at 75% to 100% capacity with COVID-19 patients had a 94% higher risk for death compared to those treated for the disease in facilities at less than 25% of capacity, the data showed.

Patients in ICUs at 25% to 50% because of COVID-19 outbreaks had a 19% higher risk for death.

Hospitals in many parts of the country have reported being overwhelmed with patients requiring ICU treatment during the pandemic. The Department of Health and Human Services reports that 79% of ICU beds were occupied as of Jan. 14, and one-fifth of U.S. hospital ICUs were 95% full.

The increased risk for death in busy ICUs could reflect the strain in resources, including staff and equipment, caused by surges in cases and demand for care -- as well as higher disease severity among the patients there, the researchers said.

"The data show that mortality increases during periods of peak demand," said Dr. Dawn M. Bravata, a physician scientist with the U.S. Department of Veterans' Affairs.

"Therefore, the more patients can do to avoid infection, the better," she said.

Of the nearly 920,000 hospital beds in the United States, about 10% of them are ICU beds, according to figures from the American Hospital Association.

Since the start of the pandemic, it has been estimated that up to 30% of COVID-19 patients require treatment in the ICU, with many needing mechanical ventilator support to breathe, research suggests.

For this study, VA researchers tracked 8,516 patients with COVID-19 admitted to 88 VA hospitals nationally between March and August 2020.

Of the patients, 1,410, or 17%, died from the disease -- roughly 44% of the deaths were in March and April, during the early stages of the pandemic -- the researchers said.

Patients with COVID-19 in ICUs operating at 75% or more of capacity during the study period had a 94% higher risk for death compared to those treated for the disease in facilities at less than 25% of capacity, the data showed.

"Given that hospitals are charged with caring for patients with non-COVID-19 critical illness as well as patients with COVID-19, future studies should seek to examine whether measures of critical care strain that include all patients in the ICU are associated with patient outcomes," Bravata and her colleagues wrote.