New Evidence Suggests Better Treatment Is Contributing to Falling COVID-19 Fatality Rates
The fatality rate among COVID-19 patients in the United States has fallen dramatically since last spring, from 6.1 percent in mid-May to 2.6 percent yesterday. That downward trend partly reflects a younger, healthier mix of patients, whose median age fell from 46 in May to 38 in August. But two new studies suggest that improvements in treatment also have helped reduce the case fatality rate.
Leora Horwitz and other researchers at NYU Langone Medical Center in New York City looked at outcomes for more than 5,000 hospitalized COVID-19 patients, taking into account age, sex, comorbidities, vital signs at admission, and the results of laboratory tests. Controlling for those variables, they found that the fatality rate fell from 25.6 percent in March to 7.6 percent in August—a 70 percent drop.
“Changes in demographics and severity of illness at presentation did not fully explain decreases in mortality seen over time,” Horwitz and her collaborators note in the Journal of Hospital Medicine. “Even after risk adjustment for a variety of clinical and demographic factors, including severity of illness at presentation, mortality was significantly and progressively lower over the course of the study period.”
Horwitz et al. acknowledge the possibility of “residual confounding,” such as “a higher proportion of particularly frail patients admitted in earlier periods.” But they note that “we observed declines across all age g
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