Proportionally fewer patients treated in our hospitals for Covid-19 died over the recent winter than lost their lives during the first peak of the pandemic, according to a new analysis.
Although we admitted twice the number of inpatients in the second peak, provisional findings suggest that the relative risk of dying was 21% lower than at the beginning of the pandemic. This was after adjusting for age, sex, ethnic group and clinical co-morbidities.
These early findings of an analysis by the group’s public health team suggest that outcomes for patients improved as clinicians and scientists learned about how to manage Covid–19 and use new drugs.
Our hospitals admitted 5,895 patients between August last year and this January, compared to 2,923 in-patients between March and July 2020. One noticeable feature of the wave two cohort was that it comprised more younger people.
A greater proportion were of Asian heritage (particularly Bangladeshi) – one third of the cohort, compared to a quarter in the first peak. The proportion of black patients fell from 17% to 11%, and the proportion of white patients from 38% to 33%.
About one in six Covid-19 patients were admitted to intensive care. The odds of this happening peaked among 60-69 year-olds, particularly men. Compared to white patients, black patients were 45% more likely to receive intensive care, and Asians 39% more likely.
The findings are highlighted in a report to the trust board on our programme to embed equity in the planning and delivery of services. They build on the pioneering research of Vanessa Apea and colleagues last year which found that Asian and black patients with Covid-19 were at increased risk of death (after adjusting for age and sex).
A separate but similar analysis established that survival rates across the Barts Health group were higher than the national average. More detailed analysis on the wave two patients is now being carried out.
Ian Basnett, our public health director, said early data suggests patients from Asian ethnic groups are more likely to have more severe or advanced disease on admission - and to be admitted directly to intensive care - than other ethnic groups.
Dr Charlotte Hopkins, deputy chief medical officer, said: “We think the improved mortality is at least in part due to better care, including new treatments such as steroids or non-invasive ventilation.
“Our staff made tremendous efforts throughout both peaks of the pandemic to understand Covid-19 and adapt our care accordingly, and significant improvements were made both in our critical care units and on our general wards.”