Most COVID-19 patients who died in the hospital during the early phase of the pandemic were killed as a result of being put on a ventilator, according to a new study.
The analysis, published in the Journal of Clinical Investigation last month, found the majority of COVID patients who required help from a ventilator also developed secondary bacterial pneumonia.
“Our study highlights the importance of preventing, looking for, and aggressively treating secondary bacterial pneumonia in critically ill patients with severe pneumonia, including those with COVID-19,” says Benjamin Singer, a pulmonologist at Northwestern University in Illinois.
From Science Alert:
The team looked at records for 585 people admitted to the intensive care unit (ICU) at Northwestern Memorial Hospital, also in Illinois. They all had severe pneumonia and/or respiratory failure, and 190 had COVID-19.
Using a machine learning approach to crunch through the data, the researchers grouped patients based on their condition and the amount of time they spent in intensive care.
The findings refute the idea that a cytokine storm following COVID-19 – an overwhelming inflammation response causing organ failure – was responsible for a significant number of deaths. There was no evidence of multi-organ failure in the patients studied.
In other words, though COVID-19 may have put these people in the hospital, the secondary infection of bacterial pneumonia after being put on a ventilator was responsible for the higher mortality rate, a condition called Ventilator-Associated Pneumonia (VAP).
“Those who were cured of their secondary pneumonia were likely to live, while those whose pneumonia did not resolve were more likely to die,” Singer says.
“Our data suggested that the mortality related to the virus itself is relatively low, but other things that happen during the ICU stay, like secondary bacterial pneumonia, offset that.”
The researchers stressed that the findings don’t diminish the health risks of COVID-19 itself, because for the patient to even require a ventilator would mean they were already experiencing respiratory problems from the China Virus.
It’s worth bearing in mind that if a patient’s requirement for a ventilator to treat COVID-19 complications leads to VAP, this doesn’t imply that a COVID-19 infection is less dangerous, nor does it decrease the number of COVID-19 fatalities.
As the authors write in their paper, “The relatively long length of stay among patients with COVID-19 is primarily due to prolonged respiratory failure, placing them at higher risk of VAP.”
But the findings highlight a need for further study and to be cautious when making assumptions about the cause of death in COVID-19 cases. A detailed molecular analysis from the same study should reveal more about what makes the difference between recovering or not from VAP.
The study confirms mainstream media reports from 2020 that approximately 90% of COVID patients who were put on ventilators died.
The difference is, the media claimed the high mortality was due to preexisting health conditions and the severity of COVID — not ventilator-induced pneumonia.
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