The proportion of under 60s present in the intensive care unit is increasing under the effect of the British variant. For those over 70, the trend is downward, a direct effect of the vaccination campaign.
- While they represented only 30% of entries during previous waves of contamination, people under 60 today represent almost 50% of new entrants to intensive care.
- These younger patients admitted to critical care stay on average longer in intensive care because their condition deteriorates more slowly.
- A pre-published study concluded that the English variant causes an increased risk of hospitalization of approximately 64%.
In intensive care units, patients with a severe form of Covid-19 have not stopped arriving, but their profiles have evolved. The median age of Covid-19 patients in intensive care has fallen from 65 years old in 2020 to 63 years old in 2021, according to the Assistance Publique – Hôpitaux de Paris (AP-HP). “This decrease may seem small, but this figure is not enough to reflect the importance of the signal that we see”noted Professor Antoine Vieillard-Baron, head of the intensive care-resuscitation department at the Ambroise-Paré hospital, in World. While they represented only 30% of entries during previous waves of contamination, people under 60 today represent almost 50% of new entrants to intensive care.
Longer stays in intensive care
The admission curves cross between the oldest and the youngest. In Île-de-France, the proportion of people over 80 has fallen by 14 points in two and a half months, going from almost half to a small third of hospitalized people, while that of people under 60 has climbed by almost nine points. , going from less than 16% of hospitalized patients to almost a quarter. “These results suggest an average increase in the severity of cases in patients aged 15 to 64, more marked in young adults.”, indicated Public Health France in its epidemiological update of Thursday March 18. “What is significant is that we have far fewer intensive care patients over the age of 70, which greatly contributes to lowering the averageunderlines the professor at the Lille University Hospital, François-René Pruvot. They are only 25% of patients, against 36% in the second wave, so this may be an effect of vaccination.”
These younger patients admitted to critical care stay on average longer in intensive care because their condition deteriorates more slowly than older patients. The AP-HP noted that the length of stays in intensive care with intubation has increased from 17 days on average in 2020 to 21 days in recent weeks. Doctors have also noted an increasing number of direct admissions to critical care units, bypassing more traditional hospitalization.
The British variant in question
“The only explanation I see is the English variantadvances Yves Cohen, head of the intensive care unit at the Avicenne hospital in Bobigny, because this age curve has evolved for me in parallel with that of the progression of the variant.” This explanation is not shared by all and in particular Professor Antoine Vieillard-Baron who sees in it the consequence of an increased circulation of the virus among the youngest. “The phenomenon is correlated with an increase in the incidence rate which exploded among 20-60 year olds, while its progression is less among older people, the infection circulates more in this younger age group.“, he believes. Regarding the higher severity of the virus in the youngest, it also refers to the B.1.1.7 variant of SARS-CoV-2, known as the British variant. “What is more unexpected, on the other hand, is that the virus leads these younger people so much to critical care. Is it the effect of the more severe variant, it is not excluded”, he judges.
This reality observed by the resuscitation services responds to new studies which show that the British variant is more contagious and more deadly than the “classic” strain of the virus. A study pre-published on March 2 suggests that this variant also leads to more severe forms of Covid-19. The analysis of all positive cases detected by an RT-PCR test between 1er January and February 9 in Denmark led the researchers to observe an increased risk of hospitalization of approximately 64% in the event of infection with the English variant. This risk even reaches 84% for those under 30 years old.
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