High rates of COVID-19 in a community reduces survival rates among hospitalized patients

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The spread of COVID-19 in a hospital’s surrounding community can affect the survival rates of patients, a new study suggests.

Researchers found that, overall, coronavirus mortality rates declined during the first six months of the pandemic.

However, hospitals in counties where infection rates increased during the late spring and early summer had a higher percentage of patients who died or were admitted to hospice care. 

As cases continue to increase across the nation, the team, from the Perelman School of Medicine at the University of Pennsylvania, says this could lead to hospitals becoming overburdened, which will, in turn, raise mortality rates. 

A new study from the University of Pennsylvania found that overall coronavirus mortality rates declined from 16% to 9%, survival rates were worst in counties with high COVID-19 case rates. Pictured: Clinicians prepare a COVID-19 patient for RotoProne therapy in the ICU at Sharp Grossmont Hospital in La Mesa, California, December 14

A new study from the University of Pennsylvania found that overall coronavirus mortality rates declined from 16% to 9%, survival rates were worst in counties with high COVID-19 case rates. Pictured: Clinicians prepare a COVID-19 patient for RotoProne therapy in the ICU at Sharp Grossmont Hospital in La Mesa, California, December 14

Hospitals located in counties in states like New York, New Jersey and Connecticut saw worse survival rates than in Midwestern counties

Hospitals located in counties in states like New York, New Jersey and Connecticut saw worse survival rates than in Midwestern counties

‘We have known that individual risk factors like age and gender, comorbidities such as obesity, and whether someone is a nursing home resident, are all part of what determines whether patients have a good or bad outcome,’ said lead investigator Dr David Asch, a professor of medicine at the University of Pennsylvania.

‘But our research shows it also matters where a patient is admitted,’ 

For the study, published in JAMA Internal Medicine, the team looked at almost 40,000 coronavirus patients admitted to 955 hospitals across the U.S. between January 1 and June 30.

They analyzed how many died within 30 days of admission or were discharged to hospice, which indicates end-of-life care.

On average, nearly 12 percent of all COVID-19 patients who were hospitalized died. 

Men were about 1.3 times more likely to die than women and patients older than 85 years older were nearly 15 times more likely to pass than those aged 18 to 45.

Additionally, patients admitted within the first 90 days of 2020 were 2.6 times more likely to die than those admitted at least five months into 2020. 

Researchers also found that the mortality rate was just nine percent among the hospitals with the best outcomes in comparison with more than 15 percent for those with the worst outcomes. 

Next, the team split data into two periods: one from January 1 to April 30 and another from May 1 to June 30.

Over the six months, COVID-19 mortality rates declined from 16 percent in the early period to nine percent in the later period.

What’s more, of 398 hospitals, 397 improved survival rates, by at least a slim margin. 

Researchers say this could be due to better knowledge of the disease and how to treat, but they also found a different factor. 

‘Improvement, in general, likely comes from experience in how to manage oxygenation for these patients, as well as new treatments like dexamethasone,’ Asch explained. 

‘But…the factor most strongly associated with outcomes or their improvement, based on our data, was how much COVID-19 spread there was in the hospital’s surrounding community.’  

Results showed that hospitals situated in counties with county-level coronavirus case rates had worse death rates.

This was especially prevalent in the Northeast, with counties in New York, New Jersey and Connecticut, where infections were highest. 

Hospitals located in counties where case rates declined during this period, namely the Midwest, had the most improvement over time.   

‘With the current surge this winter, I’m worried hospitals will give up some of the positive gains from the summer,’ Asch said. 

‘Not only will raw death numbers go up, but death rates may go up as well.’  

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