Covid-19 in Germany: only two out of three patients survive artificial ventilation

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Doctor with breathing tube

Fortunately, severe courses of Covid-19 are comparatively rare, but of those corona patients who came to the hospital, one in five had to be treated in the intensive care unit. If artificial ventilation became necessary, only two out of three people survived on average. This is the result of an evaluation by the Helios clinics with more than 1900 patients from Germany.

For the study, doctors collected information from all corona patients who were treated in a Helios clinic between February 12 and June 12. The group owns more than 80 hospitals across Germany. Almost 80 percent of the patients could be discharged from the clinic by the time of the evaluation. 16.6 percent died, 3.6 percent were still in inpatient treatment. The figures are therefore comparable with other EU countries.

"An important finding from the Covid-19 register is that the course of the disease in the Covid-19 patients admitted to our hospitals is no less critical than in countries such as Italy, France, Great Britain and Belgium, in which compared with of the population, there were many more Covid-19 cases and Covid-19-related deaths than in Germany, "says Julius Dengler, chief physician at the Clinic for Neurosurgery at the Helios Clinic in Bad Saarow. 

In other words, comparatively few people were infected with Sars-CoV-2 during the first wave in Germany. However, if someone became so seriously ill that he had to be treated in the intensive care unit, the researchers found that his chances of survival were as high as in more severely affected neighboring countries. In Lombardy, for example, around 26 percent of Covid 19 patients who were given a place in the intensive care unit died, according to a study. When the German Helios clinics were examined, the value was 29 percent. The results show how important it is to keep the number of infections low.

Risk factor: age and gender

Most of those affected in the German Helios study deteriorated so much in the first week after arriving at the hospital that they had to be transferred to the intensive care unit. This was significantly more common with men: While 27 percent of hospital patients had to be treated in intensive care, women only had 16 percent, report the doctors in the journal "Clinical Microbiology and Infection".

Men also had to be artificially ventilated more often on average. Once in the intensive care unit, however, the gender differences canceled each other out.

The results also confirm the observation that age can have a strong influence on the course of the disease. The proportion of those treated in the intensive care unit was greatest among patients between 60 and 69 years of age (31 percent) and between 70 and 79 years of age (29 percent). The researchers explain the fact that patients at an even older age were transferred to the intensive care unit less often with living wills that exclude artificial ventilation.

AOK evaluation: even more pessimistic

The data of the analysis represent around seven percent of all Covid-19 patients who were treated in hospital in Germany until mid-June. Apart from that, there is already a large corona study by the health insurance company AOK, which includes data from more than 10,000 hospital patients.

The results of the AOK evaluation are even more pessimistic than those of the Helios researchers. Accordingly, not 17, but 22 percent of corona patients died in the hospital. However, the AOK insured are not representative of the German population either, write the authors of the current study. They say they are more likely to have chronic conditions such as diabetes, which may explain the differences in deaths.

From the data from the Helios clinics, conclusions can only be drawn about hospital patients, not about Covid-19 patients with mild progressions. According to the current situation report from the Robert Koch Institute, around 16 percent of the people in whom Sars-CoV-2 was detected had to be treated in hospitals. Since many infections remain unknown, the proportion of hospital patients among all infected is probably significantly lower.

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