병원 입원 환자 코로나 사망률 현저히 낮아져 Death rates have fallen by 18% for hospitalized COVID-19 patients as treatments improve

Death rates have fallen by 18% for hospitalized COVID-19 patients as treatments improve

By Monica Gandhi 12 hours ago

Two large recent studies show that people hospitalized for COVID-19 in March were more than three times as likely to die as people hospitalized for COVID–19 in August.

Vox

"올 3월 이후 병원 입원환자 코로나 사망률 3배 이상 낮아져" 두 개의 큰 최근의 연구는 3월에 COVID-19로 입원한 사람들이 8월에 COVID–19로 입원한 사람들보다 3배 이상 사망할 가능성이 높다는 것을 보여준다. 첫 번째 연구는 뉴욕에 있는 세 병원의 데이터를 사용했다. 이들 병원에서 코로나바이러스로 입원한 사람의 사망 확률은 3월 25.6%에서 8월 7.6%로 낮아졌다. 영국의 생존율을 조사한 두 번째 연구에서도 비슷한 개선점을 발견했다 지속적이고 현저한 개선 지난 3월 뉴욕 3개 병원에 COVID-19로 입원한 1724명 중 430명이 사망했다. 지난 8월에는 134명이 입원해 5명이 숨졌다. 이러한 숫자의 변화는 병원에 누가 도착하는가에 의해 결정될 수 있다. 예를 들어 나이든 사람들만 아프면, 사망률이 더 높아질 것이다. 그러나 연구원들은 그들의 계산에서 이를 고려했다. 무엇이 이러한 입원 사망률의 감소를 야기하는지 더 잘 이해하기 위해, 연구자들은 입원 환자의 나이, 인종과 민족성, 개인이 병원에 도착했을 때 필요한 산소 지원의 양, 과체중, 흡연과 같은 위험 요소 등 가능한 여러 가지 교란 요인을 설명하였다.인화, 고혈압, 당뇨병, 폐질환 등등. 이들의 구체적인 상황이 어떻든 간에 3월 COVID-19로 입원한 사람은 8월에 입원한 사람보다 사망할 확률이 3배 이상 높았다.. View full text https://www.livescience.com/covid-19-death-rates-falling-treatments.html

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The first study used data from three hospitals in New York City. The chance of death for someone hospitalized for the coronavirus in those hospitals dropped from an adjusted 25.6% in March to 7.6% in August. The second study, which looked at survival rates in England, found a similar improvement.

Continuous, significant improvement

In March, out of 1,724 people hospitalized for COVID-19 in the three New York hospitals, 430 died. In August, 134 were hospitalized and five died. This change in the raw numbers could be driven by who was arriving at the hospital – if only older people were getting sick, the death rate would be higher, for example – but the researchers controlled for this in their calculations.

To better understand what was causing this decrease in hospitalization death rate, the researchers accounted for a number of possible confounding factors, including the age of patients at hospitalization, race and ethnicity, the amount of oxygen support individuals needed when they got to the hospital and such risk factors as being overweight, smoking, high blood pressure, diabetes, lung disease and so on.

The Conversation

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No matter what their specific situation, a person hospitalized in March for COVID-19 was more than three times as likely to die as one hospitalized in August.

The study in England looked at hospitalized coronavirus patients who were sick enough to go to a high-dependency unit (HDU) – one where they were monitored closely for oxygen needs – or the intensive care unit (ICU). As in the New York study, the researchers also accounted for confounding factors, but they calculated survival rates instead of mortality rates.

Looking at 21,082 hospitalizations in England from March 29 to June 21, 2020, the authors found a continuous improvement in survival rates of 12.7% per week in the HDU and 8.9% per week in the ICU. Overall, between March and June the survival rate improved from 71.6% to 92.7% in the HDU and from 58% to 80.4% in the ICU. These increases in survival after hospitalization for the coronavirus in England mirrored the changes in New York City.

Better treatments and better care are responsible

The main reason researchers think coronavirus patients are doing better is simply that there are now effective treatments for the virus that didn’t exist in March.

I am a practicing infectious disease doctor at the University of California, San Francisco, and I have witnessed these improvements firsthand. Early on, my colleagues and I had no idea how to treat this brand-new virus that burst onto the scene in late 2019. But over the spring, large studies tested different treatments for COVID-19 and we now use an antiviral called remdesivir and a steroid called dexamethasone to treat our hospitalized coronavirus patients.

Along with these new treatments, physicians gained experience and learned simple techniques that improved outcomes over time, such as positioning a patient with low oxygen in a prone position to help distribute oxygen more evenly throughout the lungs. And as time has gone on, hospitals have become better prepared to handle the increased need for oxygen and other specialized care for patients with the coronavirus.

Though improvements in care and effective drugs like remdesivir and dexamethasone have helped greatly, the virus is still very dangerous. People with severe cases can suffer prolonged symptoms of fatigue and other debilitating effects. Therefore, other treatments should be and are still explored.

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https://www.livescience.com/covid-19-death-rates-falling-treatments.html

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