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For COVID-19 ICU Patients, Death Linked to COVID-19 ICU Strain

TUESDAY, Jan. 19, 2021 -- For patients with COVID-19 in the intensive care unit (ICU), mortality is associated with COVID-19 ICU strain, according to a study published online Jan. 19 in JAMA Network Open.

Dawn M. Bravata, M.D., from the Health Services Research and Development Center for Health Information and Communication in Indianapolis, and colleagues examined whether COVID-19 mortality is associated with COVID-19 ICU strain in a cohort study conducted among 8,516 veterans with COVID-19 admitted to 88 Veterans Affairs hospitals.

The researchers found that mortality varied over time, with 22.9, 25.0, 15.5, 13.6, 12.5, and 12.8 percent of patients dying in March, April, May, June, July, and August, respectively. Compared with patients treated during periods of low COVID-19 ICU demand, those treated in the ICU during periods of increased COVID-19 ICU demand had increased mortality (adjusted hazard ratio for all-cause mortality, 0.99 [95 percent confidence interval, 0.81 to 1.22; P = 0.93] for patients treated when demand was >25 to 50 percent; 1.19 [95 percent confidence interval, 0.95 to 1.48; P = 0.13] when demand was >50 to 75 percent; and 1.94 (95 percent confidence interval, 1.46 to 2.59; P < 0.001] when demand was >75 to 100 percent). For patients with COVID-19 not in the ICU, no association was seen between COVID-19 ICU demand and mortality. The association between COVID-19 ICU load and mortality varied over time.

"Public health officials and hospital administrators may seek to prevent high COVID-19 ICU demand to optimize outcomes for patients with COVID-19," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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