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Early study into UK Covid-19 critical care points to risk factors

Most patients admitted to critical care services with confirmed coronavirus need to be placed on mechanical ventilation within 24 hours, an audit of 196 patients treated in England, Wales and Northern Ireland shows.

Data on Covid-19 patients in their first day in critical care also paints a picture of who may be most at risk.

The report from the Intensive Care National Audit and Research Centre found that of the 196 patients admitted to participating hospitals up to the 19 March, 16 died, 17 were discharged and 163 remained in critical care. More than half the patients were being cared for in London.

Almost three quarters (139) were male and the median age of those included in the audit, which is the first to outline in detail the case mix of UK patients in intensive care, was 64 years.

Around a third had a body mass index of 25 to 30 and another third a BMI of between 30 and 40. A further 13 patients had a BMI over 40, the ICNARC report said.

During the first 24 hours after admission, 132 patients received mechanical ventilation, the figures show. None of the patients admitted were pregnant.

Some detail on medical history shows that 13% of patients had required some assistance with daily activities before they had become ill with Covid-19.

Overall 18 patients were recognised as having a ‘severe’ co-morbidity’ including renal disease and being immunocompromised.

Current figures (March 24) show that 422 patients in the UK have died after testing positive for Covid-19.

Giving evidence to the science and technology health select committee, Professor Neil Ferguson from Imperial College – the expert who provided the modelling data which prompted the changes in UK policy on dealing with the pandemic – said with the extra measures put in place, he expected the NHS to cope.

He told MPs: ‘There will be some areas that are extremely stressed but we are reasonably confident — which is all we can be at the current time — that at the national level we will be within capacity.’

He said: ‘If the current measures work as we would expect them then we will see intensive care demand peak in approximately two to three weeks and then decline.’