Death rates drop for seriously ill Covid-19 patients

The coronavirus struck the United States earlier this year with devastating force. In April, it killed more than 10,000 people in New York City. By early May, nearly 50,000 nursing home residents and their caregivers across the country had died.

But as the virus continued its rampage, infecting nearly 8.5 million Americans, survival rates, even of seriously ill patients, appeared to be improving. At one New York hospital system where 30% of coronavirus patients died in March, the death rate had dropped to 3% by the end of June.

Doctors in England observed a similar trend.

“In late March, 4 in 10 people in intensive care were dying. By the end of June, survival was over 80%,” said John M. Dennis, a University of Exeter Medical School researcher who is first author of a paper about improved survival rates in Britain.

As elderly people sheltered inside and took precautions to avoid infection, however, more of the hospitalised patients were younger adults, who were generally healthier and more resilient. By the end of August, the average patient was younger than 40.

Were the lower death rates simply a function of the demographic changes, or a reflection of real progress and medical advances in treatment that blunted the effect of the new pathogen?

Researchers at NYU Langone Health who zeroed in on this question, analysing the outcomes of more than 5,000 patients hospitalised at the system's three hospitals from March through August, concluded the improvement was real. 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 death rates had dropped significantly, to 7.6% in August, down from 25.6% in March.

“This is still a high death rate, much higher than we see for flu or other respiratory diseases,” said Dr. Leora Horwitz, director of NYU Langone’s Center for Healthcare Innovation & Delivery Science and senior author of the paper in Journal of Hospital Medicine. “I don’t want to pretend this is benign. But it definitely is something that has given me hope.”

A combination of factors contributed to the improved outcomes of hospital patients, the authors of the two studies and other experts said. As clinicians learned how to treat the disease, incorporating the use of steroid drugs and non-drug interventions, they were better able to manage it.