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High mortality for Covid-19 patients outside the ICU, finds new study in Greece

Mortality among Covid-19 patients outside the Intensive Care Unit has been particularly high, a new study conducted in Greece has found. The majority of Covid-19 patients who did not have the opportunity to be admitted to ICU have died, a new study conducted by Assistant Professor of Public Health at the School of Medicine of the European University of Cyprus, Theodoros Lytras.

The study examined the period September 2021 to April 2022 and found that mortality increased by 21% compared to the previous study by Professors Sotiris Tsiodras/Thodoros Lytras  conducted from the start of the pandemic until May 2021.

The Tsiodras/Lytras study had caused a storm of reactions, exposing the government for its handling of the pandemic and Public Health, as it confirmed the relationship of mortality with non-ICU intubations and in general the high number of deaths with the limited possibilities of the Greek Public health Care system.

The new study is based on the analysis of data from 14,011 intubated patients with Covid-19. Shocking result: 10,466 of those, that is 74.7% died.

The analysis shows a deterioration in the mortality of patients in and out of the ICU by 21%, compared to the first part of the study, which spans from the beginning of the pandemic to May 2021.

According to the data, those who did not have the opportunity to be admitted to the ICU ended up dying.

Specifically:

  • Almost all 1,084 patients (97.7%), against the 9,382 hospitalized in ICU, of which 72.7% ended up.
  • Mortality of those intubated outside the ICU compared to those intubated in the ICU appears twice as big.

In the second study, it is proven that the burden of mortality is greater for those hospitalized in health structures of the province (+64%) compared to the hospitals of the Attica basin, while before September 1 the difference was 36% (a percentage similar to that of the first observation phase).

The two Professors also find that from August ’21 onward, deaths and intubations gradually increase as there is an increasing presence of the Delta mutation and more specifically, from November 2021 onward.

The Omicron mutation – from January until April 2022 – seems to have worsen the epidemic wave, which, however, moving towards spring shows a de-escalation.

Finally, the two scientists note that they did not detect any appreciable correlation of vaccination against Covid-19 with the mortality for seriously ill patients.

“Vaccine is *terribly effective* at preventing severe COVID-19 disease and death. But if someone is ALREADY unlucky enough to become seriously ill despite vaccination, it is the quality of care that determines their chances of survival.”

Vaccination plays no further role there, as is logical and obvious”, Lytras said on one of his posts on Twitter, where he presented data of his research to make them available to the general public.

The Abstract of the study is here.

Abstract

Background Our previous analysis showed how in-hospital mortality of intubated COVID-19 patients in Greece is adversely affected by patient load and regional disparities. We aimed to update this analysis to include the large “delta” and “omicron” waves that affected Greece during 2021-2022, while also considering the effect of vaccination.

Methods Anonymized surveillance data were analyzed from all COVID-19 patients in Greece intubated between 1 September 2020 and 4 April 2022, and followed up until 17 May 2022. Poisson regression was used to estimate the hazard of dying as a function of fixed and time-varying covariates.

Results Mortality was significantly higher above 400 patients, with an adjusted Hazard Ratio of 1.22, 95% CI: 1.09-1.38), rising progressively up to 1.48 (95% CI: 1.31-1.69) for 800+ patients. Hospitalization away from Attica region was also independently associated with increased mortality, as was hospitalization after 1 September 2021 (HR=1.21, 95% CI: 1.09-1.36). Vaccination did not affect the mortality of these already severely ill patients.

Conclusion Our results confirm that in-hospital mortality of severely ill COVID-19 patients is adversely affected by high patient load and regional disparities, and point to a further significant deterioration after 1 September especially away from Attica and Thessaloniki. This highlights the need for urgent strengthening of healthcare services in Greece, ensuring equitable and high-quality care for all.

PS No surprise that many Greeks lash out against the government, the Prime Minister and the two health ministers during the pandemic. Comments and Quote Tweets are full of accusations, but you think anyone in the gov’t cares?

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