> More than half of patients on mechanical ventilation were extubated (57 percent, n=17/30) and nearly half of all patients (47 percent, n=25/53) were discharged from the hospital following treatment with remdesivir.
Death rate for patients on ventilators has been something like 80 percent.
It's a nice signal, but yeah, theres a reason they're running a large randomized controlled trial right now for FDA approval - they arent likely to get approval just based on this.
"Results Of the 15 757 patients admitted, a total of 5183 (33%) received mechanical ventilation for a mean (SD) duration of 5.9 (7.2) days. The mean (SD) length of stay in the intensive care unit was 11.2 (13.7) days. Overall mortality rate in the intensive care unit was 30.7% (1590 patients) for the entire population, 52% (120) in patients who received ventilation because of acute respiratory distress syndrome, and 22% (115) in patients who received ventilation for an exacerbation of chronic obstructive pulmonary disease. Survival of unselected patients receiving mechanical ventilation for more than 12 hours was 69%. The main conditions independently associated with increased mortality were (1) factors present at the start of mechanical ventilation (odds ratio [OR], 2.98; 95% confidence interval [CI], 2.44-3.63; P<.001 for coma), (2) factors related to patient management (OR, 3.67; 95% CI, 2.02-6.66; P<.001 for plateau airway pressure >35 cm H2O), and (3) developments occurring over the course of mechanical ventilation (OR, 8.71; 95% CI, 5.44-13.94; P<.001 for ratio of PaO2 to fraction of inspired oxygen <100).
"Conclusion Survival among mechanically ventilated patients depends not only on the factors present at the start of mechanical ventilation, but also on the development of complications and patient management in the intensive care unit."
Yes, I think both NYC and Louisiana were seeing death rates above 80% for intubated patients, which is why they are starting to think they need to change the protocol.
In the remdesivir study, death rates on invasive ventilator patients was 13% which is much lower than expected at this point.
They could have selected withing ventilated patients for patients more likely to survive if they thought compassionate use might be most effective in patients that have a shot. They're running a large controlled trial so we should know more soon enough
Death rate for patients on ventilators has been something like 80 percent.