Three in 10 Covid-19 patients admitted to ICU died, says report

Three in every 10 patients admitted into intensive care with Covid-19 died, with mortality rates spiking during the third wave of the virus at the start of this year, according to a new report.

More than a third of the 854 Covid-19 patients in intensive care died in the period between January and May 2021, with 303 fatalities.

Ireland had a “significantly” lower mortality rate for patients in ICU with the virus compared to Britain, a healthcare audit report found.

The report from the National Office of Clinical Audit (NOCA) said the overall mortality rate of ICU patients with Covid-19 in Ireland was about 30 per cent, compared to 40 per cent in Britain.

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Of the 1,813 people admitted to ICU with the virus between early April and late October 2020, 530 died, the report said.

More than half of the people sent to ICU were aged 60 or older, and most were transferred to intensive care after deteriorating on hospital wards.

The report, published on Thursday, linked “significantly less” mortality rates in ICUs in Ireland to having more organ supports available for longer periods.

The incidence of Covid-19 and numbers in hospital and ICU were “considerably greater in the UK than in Ireland”, which meant Irish hospitals were able to support patients in ICU for longer periods, “which led to improved outcomes”, the report said.

The number of Covid-19 patients in ICU peaked at 215 people on January 26th, 2021. There were 27 patients sent to ICU in one day on January 21st.

Deaths peaked on February 24th, when 11 patients died in ICU in a single day.

Over the course of the pandemic 1,641 people were admitted into ICUs in public hospitals with Covid-19. Fifteen children were admitted into intensive care with the virus, and there were 27 ICU admissions across five private hospitals.

The report said there was a “fear” ICU capacity would be “overrun” at the start of the pandemic, similar to early scenes in Italy.

However, it said this did not materialise, in part due to the redeployment of staff and the expansion of intensive care units into other areas.

This increased capacity by 37 per cent up to about 350 beds, it said.

Some 28 per cent of those in intensive care were between 60 and 79 years of age. There were 60 patients in their 20s admitted to ICU overall.

The report said 23 pregnant women were sent to ICU between December 2020 and the end of August 2021, all of whom had survived to date.

The audit said “an unvaccinated person was much more likely to be admitted to ICU than a vaccinated person”.

This July there were six vaccinated people in ICU with Covid-19, compared to 32 unvaccinated people.

The report said “certain nationalities were more heavily represented among Covid-19 patients in ICU, particularly among the unvaccinated group”.

“A significant number of patients born in Ireland had been fully vaccinated, whereas none of the patients from a range of countries in Eastern Europe, Asia and Africa had been,” it said.

Unvaccinated patients continue to make up the majority of Covid-19 admissions, it said.

The report said that those who were vaccinated in ICU often were older and had pre-existing medical conditions.

“These factors are likely to have contributed to their need for ICU admission. As would be predicted from their older age and higher rate of pre-existing conditions, ICU mortality was higher in this group,” the report said.