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If a COVID-19 patient ends up on a ventilator, what are the odds of survival? I haven’t found good data from non-China countries. I found one Chinese study of ~200 patients and it was quite discouraging. Only one of the 32 patients on a ventilator in the ICU survived.
I’ve been reading Karl Denninger’s blog and, if memory serves, he says that once you’re put on mechanical ventilation in a hospital, your odds of surviving that hospital stay are only 50:50. And a year later, of all ventilator patients, only three in 10 are still alive.
I ran across a 2015 article on long-term survival of critically ill patients treated with prolonged mechanical ventilation. “Prolonged” meaning over 14 days in this instance. I’ve only read the abstract. It’s a multi-country meta-analysis involving both acute and post-acute hospitals. Here are a few factoids:
- overall mortality at one year was ~60% (only 4 in 10 still alive)
- U.S. post-acute care hospital mortality one year out was 70%, worse than pooled non-US countries (so only 1 in 3 still alive, as Denninger says)
BTW, in the U.S. if you’re on mechanical ventilation for 12-14 days and your physicians figure you’ll need prolonged ventilation, you’ll get a tracheostomy.
COVID-19 patients on ventilators seem to need it for about 10 days. So the study at hand has little to do with them, in general. On the other hand, if a COVID-19 patient also has COPD, emphysema, or moderate-to-severe asthma, prolonged ventilation may well be in their future.
I’ve taken care of these prolonged ventilator patients in what we in the U.S. call long-term acute care hospitals (LTACHs). Many of these patients have Foley indwelling catheters which predispose them to urinary tract infections. They’re also prone to pressure sores, pneumonia, deep vein thrombosis, and life-threatening blood clots in the lungs. They need so much blood work done, they start to feel like a pin cushion. It’s a tough life, for sure. Not to mention the cost, which runs into the millions.
If you have data on the survival rates of U.S. COVID-19 patients on mechanical  ventilation, please leave a comment below or email me at stevepakermd AT gmail DOT com. The medical literature should have published date in a month or so, in an ideal world.
Steve Parker, M.D.
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