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Stark and sobering new intensive care study reveals the profiles of those in intensive care with Covid-19 – Wales Online

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Two-thirds of people who’ve been admitted to intensive care with coronavirus in Wales have been male while more than half live in more deprived areas.

According to a study of intensive care patients, more than a third of those admitted with coronavirus are also classed as obese.

The study, carried out by the Intensive Care National Audit and Research Centre, looked at the differences between patients in intensive care in the first and second waves of the pandemic.

Based on 528 patients critically ill with confirmed Covid-19 between September 1 and January 7 (second wave), and a further 403 patients admitted up to August 31 (first wave), the study found that the average age of those in intensive care has remained broadly similar.

The mean age of those in intensive care in the second wave is 59 compared to 57 in the first wave.

Similarly, men have been hit harder by the virus than women, with 67% of all intensive care patients being men in both waves.

Men aged in their 60s were more likely to need intensive care while those from Asian backgrounds and deprived areas were disproportionately affected.

While the majority of patients in intensive care were reported to be white, 6% of patients were classified as Asian despite the fact that ethnic group make up just 2.4% of the population (based on 2011 census ward data).

According to the study, nearly four in ten people admitted to intensive care died during the second wave. A similar number have been discharged from critical care while 135 patients (25%) are reported to be still receiving critical treatment.

Of those discharged from critical care, nearly half remain in an acute hospital.

The study also revealed that more than half of patients entering critical care since September 1 live in more deprived areas in Wales.

Using a deprivation score from 1 to 5, more than half of patients scored 4 or 5, representing the most deprived postcodes in Wales. The number of patients living in the most deprived areas is double the number living in the least deprived areas.

Data has shown that the rate of deaths in the most deprived areas of Wales has been significantly higher than in wealthier parts of the nation since the start of the pandemic although reasons for why this might be are still unclear.

Index of multiple deprivation

Patients with confirmed Covid-19 (%)

1 (least deprived)

14.7
2 14.7
3 15.1
4 26.7

5 (most deprived)

28.8

There has been a noticeable change in the approach to critical care, with improvements in treatment seeing shorter durations in intensive care.

Intensive care consultant Matt Morgan said improved treatment had now led to vastly improved outcomes for Covid patients in Wales.

Dr Morgan, who works at the University Hospital of Wales in Cardiff, told WalesOnline h e was seeing half of the patients admitted to intensive care were dying.

“This increases for those over 70, and may be as high as eight or nine out of ten for those over 80,” Dr Morgan explained.

Yet conversely, he says that is actually a sign of optimism because only a smaller percentage of patients are going into intensive care in the first place because of improvements in how medics are treating the virus. Overall, more patients are now more likely to survive with Covid than ever before. But the chances in intensive care are not good.

“This is just the patients on breathing machines,” Dr Morgan added.

“Overall the chance of surviving Covid in every age group is the best it has ever been.”

Those who have survived Covid in the second wave spent an average of just eight days in critical care compared to 15 days in the first wave. However, the study notes that the results for patients admitted from September 1, 2020 are biased towards patients with shorter lengths of stay in critical care prior to discharge or death, i.e. those who died or recovered quickly.