In the ICU, doctors see rise in Covid cases but less severe disease

For more than three years, Dr. Christopher Ohl has been treating COVID-19 patients in the intensive care unit of Atrium Health Wake Forest Baptist in North Carolina.

Recently, however, he’s noticed an improvement in his patients: They aren’t as ill as previously.

“What we’re seeing now is our patients who are admitted with Covid pneumonia in the ICU tend to respond faster to treatment, they’re less likely to die, and they’re more likely to get discharged earlier,” said Ohl, also an infectious diseases professor within the Wake Forest University School of Medicine. “They don’t seem to be as sick with it as they were two years ago.”

It’s a trend that other ICU doctors have observed also, even though hospitalizations for Covid continue to increase.

The risk of severe complications and lengthy hospital stays are becoming less frequent compared to a few years ago, according to doctors. Cameron Wolfe an expert on infectious diseases and Associate Professor of Medicine at Duke University School of Medicine. Duke University School of Medicine.

“Generally speaking, they don’t get that really horrid hyper-inflammatory disease that we were seeing a few years ago,” Wolfe stated. “We still see it to some extent, but it’s not as dramatic as it was.”

Over 17,400 people across the U.S. were hospitalized with Covid in the week ending in August. 26 According to Centers for Disease Control and Prevention the Centers for Disease Control and Prevention. This is an increase of 15.7 percent increase from the week preceding. Hospitalizations have been increasing since the beginning of July, following reaching an all-time low.

This map from CDC shows the percentage change in the number of hospital admissions related to Covid in the week ending Aug. 20.CDC

There are many reasons Covid patients may not be as sick as they were in the past, even if they do end up in hospital.

The most recent of the om subvariants of icronthat have developed and are now in circulation “are not as nasty” as the previous versions like delta or even the initial strain that first spread across the nation, Ohl said.

In the year 2020, extremely sick Covid patients showed in hospitals with signs such as abnormal blood clots. A few would suffer for one week of mild disease before their health was suddenly became ill which led to a stay in the intensive medical unit.

This kind of outcome is much rarer, Wolfe said.

Another thing to note: Patients who suffer from persistent health conditions like obesity and the T the type 2 diabetic don’t seem to be the largest portion in hospitalizations for Covid patients as as they did in the beginning of the epidemic.

“In the beginning, that’s who it really targeted,” said Dr. Joshua Denson, director of medical critical treatment in the Tulane University School of Medicine in New Orleans.

But, Denson said, “I do think we’ve crossed a threshold where, even with these new variants, it doesn’t seem to be affecting that population like it did before.”

There is also access an antiviral drug called Paxlovid that has been demonstrated to keep people away from the hospital.

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The large majority of Americans -95% of Americans – 95 percent as per the CDC have an amount of immunity against the virus, either via vaccination, infection, or both.

“When you start to get sick with Covid, our immune systems are engaged. Rather than becoming part of the problem, they’re more part of the solution,” Ohl stated.

People who are in hospital with Covid are likely to have weak immune systems, including elderly people as well as certain cancer patients and patients who have undergone organ transplants.

“Everybody I’ve seen come to the ICU in the last six months is immunosuppressed in some way,” said Dr. Ken Lyn-Kew. He is Pulmonologist in the pulmonology department at National Jewish Health in Denver.

A lot of hospitalized Covid patients suffer from blood-related cancers Ohl explained, referring to myeloma, lymphoma, and leukemia. Some have undergone bone marrow transplants or organ transplant. They have weaker immune systems even if you’ve had a vaccination.

“In other words,” said Dr. William Schaffner an associate Professor of preventive medicine from Vanderbilt University Medical Center in Nashville, “these are people who did not respond optimally to the vaccine, or in whom their protection has waned since their last dose.”

Patients who end up being hospitalized for Covid frequently require assistance breathing, according to Dr. Bernard Camins, medical director of infection prevention at Mount Sinai Health System in New York City.

“For the most part, if someone were to come in for Covid, it’s really about oxygenation,” Camins explained. “They need oxygen that you can’t get at home.”

In the wake of this latest spike in hospitalizations due to Covid, Schaffner said he expects another increase during winter and “could be a little bit higher.”

But, “we don’t expect anything like what we had last year or the year before,” the president said.


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