Death Rates Have Dropped for Seriously Ill Covid 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 over the summer and fall, 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 percent of coronavirus patients died in March, the death rate had dropped to 3 percent by the end of June.

Doctors in England observed a similar trend. “In late March, four in 10 people in intensive care were dying. By the end of June, survival was over 80 percent,” said John M. Dennis, a University of Exeter Medical School researcher who is first author of a paper about improved survival rates in Britain, accepted for publication in the journal Critical Care Medicine. “It was really quite dramatic.”

Though the virus has been changing slowly as it spreads, and some have speculated that it has become more easily transmissible, most scientists say there is no solid evidence that it has become either less virulent, or more virulent. As elderly people sheltered inside and took precautions to avoid infection, however, more of the hospitalized patients were younger adults, who were generally healthier and more resilient. By the end of August, the average patient was under 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 impact of the new pathogen?

Researchers at NYU Langone Health who zeroed in on this question, analyzing the outcomes of more than 5,000 patients hospitalized at the system's three hospitals from March through August, concluded the improvement was real, not just a function of changing demographics. 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 that death rates had dropped significantly, to 7.6 percent in August, down from 25.6 percent 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.” ....