Latest @ICNARC report was released last night. Here’s a summary on behalf of @ICS_updates and @COVID19actuary, with thanks to @NicolaMedical for holding virtual pen last week.
Update includes 449 new patients (8,699 total); 717 new outcomes (6,860 total).
Full report 👇. /1
Update includes 449 new patients (8,699 total); 717 new outcomes (6,860 total).
Full report 👇. /1
Daily admissions remain low, though it’s increasingly clear that the peak’s run off will be slower that the ascent. Indeed it will be interesting to see whether there is continued decline over the coming weeks or if we plateau. /2 
Little change to the geographic distribution. Reminder that three of the networks with most admissions are in London. /3
Table 1 shows demographic characteristics, compared to pneumonia caused by other viruses.
More admissions in 10 weeks that 2017-19 combined!
Groups at higher risk of needing ICU care include:
- males
- non-whites
- more deprived groups (bottom 40%)
- overweight/obese. /4
More admissions in 10 weeks that 2017-19 combined!
Groups at higher risk of needing ICU care include:
- males
- non-whites
- more deprived groups (bottom 40%)
- overweight/obese. /4
Table 2 shows medical history. Compared to viral pneumonia patients, ICU admissions for COVID-19 are far less likely to need assistance with daily living (91% don’t) or have very severe comorbidities (8% do).
It is not just people “at death’s door” who fall victim. /5
It is not just people “at death’s door” who fall victim. /5
The age and sex distribution remains striking. Two thirds of the ICU patients are men aged 40-80. More men in their 40s have needed ICU care than women in their 60s! /6
As in previous weeks it is clear that Asians, Blacks and Other ethnicities are over-represented.
Compared to white ethnicity, ICU admission is
- 50% more likely for Asians
- 90% more likely for blacks
- over four times as likely for other ethnicity. /7
Compared to white ethnicity, ICU admission is
- 50% more likely for Asians
- 90% more likely for blacks
- over four times as likely for other ethnicity. /7
BMI picture is little changed. ICU admissions are about what we’d expect for healthy weight or under. There are fewer ICU admissions than expected for the ‘overweight but not obese’ group and more for obese, especially very obese. /8
Table 8 shows outcomes data by individual variables. It’s an interesting summary but we have multivariable analysis available now which is much more informative. /9
Figure 15 shows hazard ratios for various characteristics.
This is the risk of dying having been admitted to ICU.
In each case comparison to a reference group where the risk is 1.0 by definition.
So for example a patient aged 70 is twice as likely to die as one aged 60. /10
This is the risk of dying having been admitted to ICU.
In each case comparison to a reference group where the risk is 1.0 by definition.
So for example a patient aged 70 is twice as likely to die as one aged 60. /10
The hazard ratios👆tell us:
- age is highly significant, the strongest predictor by far of survival after ICU admission
- there is no statistically significant difference by sex
- Only Asian ethnicity has a statistically significant extra mortality risk compared to whites. /11
- age is highly significant, the strongest predictor by far of survival after ICU admission
- there is no statistically significant difference by sex
- Only Asian ethnicity has a statistically significant extra mortality risk compared to whites. /11
Hazard ratios👆continued:
- only the most deprived 20% have statistically significant extra mortality risk compared to the least deprived group
- BMI is significant, chance of survival falls as BMI rises
There are other more medical breakdowns available in the report. /12
- only the most deprived 20% have statistically significant extra mortality risk compared to the least deprived group
- BMI is significant, chance of survival falls as BMI rises
There are other more medical breakdowns available in the report. /12
To reiterate, tweets 4-8 show relative risk of being admitted to ICU.
Tweets 9-12 show relative risk of surviving, once admitted to ICU.
Some groups are doubly at risk, e.g. Asians.
Some are more likely to need ICU but at no extra risk once admitted, e.g. Males. /13
Tweets 9-12 show relative risk of surviving, once admitted to ICU.
Some groups are doubly at risk, e.g. Asians.
Some are more likely to need ICU but at no extra risk once admitted, e.g. Males. /13
I’ll wrap up there with thanks to @ICNARC for these informative reports and best wishes to all those working in critical care or elsewhere in the NHS who have themselves been unwell with this disease. Thanks you. /14
