Analysis to stationary Corona treatments
Infection with the novel Coronavirus SARS-CoV-2 can have each other effects. Some of the Infected to notice anything. Most infected people develop mild to moderate symptoms and without in-patient treatment back to health. But a part of ill and must be hospitalized. A lot of them do not survive, as a first Germany-wide analysis on the Basis of completed hospital cases now.
The Coronavirus SARS-CoV-2 is very infectious. It is a very dynamic and serious Situation, with a strong increase in the number of cases. In particular, older people and those with pre-existing diseases are affected by severe disease and can die from the disease. Also in a recently published analysis clearly.
Results for COVID-19-treatment
According to a recent communication about a fifth of the COVID died-19-patients and in-patients were recorded by the end of February until mid-April, 2020 in a German hospital. In patients with mechanical ventilation, the mortality was 53 per cent, which, without ventilation, with 16 percent, significantly lower. A total of 17 percent of the Patients were ventilated.
The Central results of an analysis of the Scientific Institute of the AOK (WIdO), the German Interdisciplinary Association for Intensive and emergency medicine (DIVI) and the Technical University (TU) of Berlin, which has been recently published in the medical journal “The Lancet Respiratory Medicine”.
Were evaluated the data from about 10,000 patients, and patients with a confirmed COVID-19-diagnosis of 26. February to to 19. April, 2020 in a total of 920 German hospitals were included.
The joint study provides the first nationwide population representative results for the treatment of COVID-19-Patients in Germany on the Basis of the AOK billing data, which represent almost a third of the German population. A focus is on the Situation of ventilated patients.
According to the figures, has died a total of about one-fifth (22 percent) of the inpatient COVID-19-patients and in -patients. The mortality of the men was 25 per cent, six percentage points higher than for women (19 per cent). Regardless of gender, the mortality in the older Patients was very high: 27 per cent died in the age group of 70 – to 79-Year-olds, 38 percent in the group of people 80 years and over.
High mortality rate in Ventilated
According to the report, slightly more than half of the patients had to be artificially ventilated (53 percent) died. The highest mortality rates were recorded in ventilated Patients in the age group of 70 to 79 years (63 percent), as well as in the patients aged 80 years or over (72 per cent).
In the case of the ventilated patients, the dialysis during the hospital stay due to a kidney failure in addition, subject to (27 percent of all mechanically ventilated Affected), the mortality rate of 73 percent is also very high. In the case of mechanical ventilation, women and men showed a similar mortality.
In patients without mechanical ventilation, the mortality rate was significantly lower, but reached as much as 16 percent. Here, too, the age with the mortality correlated. “The high mortality rates make it clear that in the clinics, a relatively large number of patients were treated with a very severe course of the disease. These heavy gradients, tend to relate to the elderly and the health of the already affected people, but also occur in younger patients,“ explains Jürgen Klauber, managing Director of WidO.
“Even if the infection figures in Germany at the Moment are low, should continue to be all the necessary precautions taken, the infection risk in the population as low as possible.”
Men’s ventilated significantly more frequently as women
In the study, the data of the COVID have been evaluated 19 patients and patients with and without ventilator disconnected. A total of 1.727 (17%) were ventilated of 10.021 inpatient COVID-19-Diseased artificially. A little more than three-quarters of the ventilated patients received invasive ventilation. The average age of the Patients was 68 years – both in the group of ventilated and non-ventilated Affected.
The proportion of Ventilated difference between the age groups: In the 60 – to 69-Year-old and 70 – to 79-Year-old, he was 24 or 25 percent, in the group of 18 – to 59-Year-olds, but only 15 per cent and in the patients aged 80 years and twelve percent.
“The proportion of elderly patients with mechanical ventilation is relatively low, but we can assume that in Germany, all patients could be ventilated, in which the therapist appeared, necessary. Because nationwide enough free were to at any time of the pandemic, intensive care beds available and the capacity of the ICU was busy, fortunately, never fully”, explains Christian what the authorities, spokesman of the DIVI-section “pulmonary – respiratory failure” as well as Director of the ECMO-center of the lung clinic Cologne-Merheim.
“The international comparison is due to different samples drawn from the studies of the samples difficult. But there are indications that in other countries tend to be less in the oldest elderly people with Covid-ventilated 19 – probably also due to capacity reasons.“
Interesting results, have a look at the distribution between the genders: The proportion of ventilated men was 22 per cent and was almost twice as high as in the case of the women (twelve percent), the mortality was, however, on a comparable level. “From the payroll data out this significant difference could not be explained, further research is needed”, so what the authorities.
Common Diseases Of Companion
Inpatient COVID-19-patients often have a number of comorbidities. The proportion of patients with concomitant diseases is those with mechanical ventilation is significantly higher than in those without mechanical ventilation.
So, for example, 24 percent of Patients without ventilation, heart rhythm disorders had; in the case of the patients with mechanical ventilation, it was 43 percent. Diabetes was present in 26 percent of the COVID-19-Concerned without ventilation and in 39% of the patients with mechanical ventilation.
In part longer than three weeks, ventilated
The average duration of the hospital stay, the COVID-19-Patients was 14 days. In the case of non-ventilated patients was twelve days, significantly shorter than in the case of the respiratory patient and patients with 25 days. The duration of artificial respiration was, on average, at 14 days, Median of ten days. 23 per cent of the affected Patients had to stay longer than 21 days of ventilation.
“With our evaluation of helpful Numbers for projections for the use of the hospital – and ventilator capacity. So an average of 240 ventilator days per 100 inpatient. These are to prepare for a second pandemic wave of the important Numbers. With respect to the normal hospital beds, but also in case of high infection numbers no Problem at all to expect“, explains Reinhard Busse, Professor of health care Management at the TU Berlin. (ad)