In these trying times, we’re very proud to have provided free access to Magpi for pandemic-related data collection. The fruit of one such effort was detailed in a recent paper: “Hospital Mortality and Resource Implications of Hospitalization with COVID-19 in London, UK” by Dr. Savvas Vlachos, Lead for Medical and Frank Stencil ICU at King's College Hospital NHS Trust.
In their study, Dr. Vlachos et al found that:
Most patients [61%] had treatment limitations placed upon admission. In addition to being clinically frail, serious comorbidities such as active malignancy and stroke were more common in these patients. Within the framework of generic national guidance regarding treatment escalation and ICU admission, we believe that the COVID-19 pandemic promoted more proactive communication about goals of care between physicians and their patients. In fact, the Palliative Care service in our institution faced a dramatic increase in ward referrals over the study period, but comparative data from other UK settings are lacking. The resource implications of delivering a comprehensive palliative care response during a pandemic are unknown, but likely to be substantial.
The hospital experienced a surge in critically ill patients (see graph below) and significant capacity strain — with 28% of the hospital capacity of 900 beds and 70% of the ICU surge capacity of 129 beds taken up by patients with COVID-19 — but this increased demand was met with operational changes such as redeployment of staff, reallocation of ventilators, and reconfiguration of wards for coronavirus isolation amongst other mitigating activities.
The COVID-19 pandemic led to a sudden surge in the overall number of critically ill patients across the hospital, as well as in the intensity and duration of treatments they required. This resulted in significant strain for the ICU in terms of capacity and service delivery. ICU bed capacity was effectively doubled, critically ill patients on the ward required frequent input by the outreach team, while patients in the ICU required prolonged mechanical ventilation and RRT, frequent rescue oxygenation therapies and tracheostomy.
We recommend downloading the complete study here for fuller information, including details of cohort selection, patient trajectories, service reorganization, and methodological limitations.
Newly admitted patients with COVID-19 (left) vs. overall number of patients hospitalized with COVID-19 (right)
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