Mortality rate Covid-19 higher than with comparable pneumonia

The outcome is still uncertain for a large group of patients in intensive care.But the first Dutch figures show that Covid-19 is more deadly than comparable diseases.

Marten van de Wier April 7, 2020, 1:00 am

The death rates in intensive care are much higher in Covid-19 than in other pneumonia caused by a virus. According to Niels Gritters van den Oever, board member of the NVIC internist association, this is evident from the mutual comparison system of hospitals. This examines the results of a treatment and takes into account the background and history of patients. The results of the hospitals at Covid-19 are worse than the model would expect.

Normally, the mortality on the IC from such a viral pneumonia is 15 to 20 percent. It is already clear that it is higher with Covid-19. “In some age groups it could be 50 percent,” says Grittersvan den Oever, who is also head of intensive care at the Treant Zorggroep in Emmen. “This is the worst kind of pneumonia.”

If you look at the current figures for recovery and mortality on the IC, you could get an even gloomier impression. The number of patients who have been in intensive care and recovered from hospital last night was 98. The number of people who died on the ICU was 297. That is three deaths on each survivor. But: that image is not correct.

Often patients are on the IC for three to four weeks before they recover. After that they sometimes come to a nursing ward before they go home. The deterioration and death of weaker patients often proceeds more quickly.

The vast majority of patients are still on ICU: 1409 of the 1897 who had been on IC since the epidemic began. A few hundred are still in a nursing ward. So the big wave with recovered patients is yet to come.

Overweight as a risk factor

Not only older and vulnerable patients die relatively often from the virus: this also applies to overweight people, says internist Niels Gritters van den Oever. Usually a little overweight is an advantage for a long stay in intensive care: patients have a small reserve. However, in Covid-19, patients with (mild) obesity are overrepresented in the group that dies.

Vulnerable health

The virus also spreads to patients who do not end up on the ICU. This applies to the group with the most vulnerable health in the Netherlands. According to their doctor’s estimate, they have too few reserves to survive a stay on the ICU and then recover from damage caused by prolonged ventilation.

According to a doctor’s guideline, this is the case for most in the category ‘quite vulnerable’ or higher. This group includes people who need help with activities outside the home, difficulty climbing stairs, and assistance with washing or dressing. They prefer to stay at home or in the nursing home.

Arend Arends , chairman of the Dutch Association for Clinical Geriatrics, estimates thatabout half of the frail elderly who are admitted to hospital care with a severe form of Covid-19 do not survive.

But the more vital people over 70 who do reach the IC are also overrepresented in the mortality rates. On the other hand, they make up a quarter of the survivors . InternistGritters van den Oever does not believe that Dutch doctors should refer fewer elderly people to the hospital. Whether patients heal remains partly unpredictable. “If there is a small but real chance of survival, it is worth it. There are some with such an opportunity that survive. It is precisely to give them that opportunity that we have expanded our capacity so much. ”