For over three years, Dr. Christopher Ohl has been dedicated to treating COVID-19 patients in the intensive care unit at Atrium Health Wake Forest Baptist in North Carolina. Recently, he has noted a significant change: his patients are not as severely ill as they once were.
Dr. Ohl, who also serves as a professor of infectious diseases at Wake Forest University School of Medicine, commented on this trend, stating, “What we’re observing now is that patients admitted to the ICU with COVID pneumonia tend to respond more rapidly to treatment, have a lower likelihood of mortality, and are discharged earlier. Their illness doesn’t appear to be as severe as it was two years ago.”
This observation is not unique to Dr. Ohl; other ICU doctors have noticed a similar pattern, even as COVID hospitalizations continue to rise.
Dr. Cameron Wolfe, an infectious disease expert and associate professor of medicine at Duke University School of Medicine, explained, “In general, patients are not experiencing the severe complications and extended hospital stays that were common several years ago. We still encounter such cases to some extent, but the severity is not as pronounced.”
According to the Centers for Disease Control and Prevention, just over 17,400 people in the U.S. were hospitalized with COVID-19 in the week ending on August 26, representing a 15.7% increase from the previous week. Hospitalizations have been on the rise since early July after reaching an all-time low.
Several factors may explain why COVID-19 patients are no longer as severely affected when hospitalized:
Milder Omicron Subvariants: The latest omicron subvariants circulating now are considered to be less virulent compared to earlier variants such as delta or the original strain that first emerged in the country.
Change in Patient Demographics: People with underlying chronic health conditions, such as obesity and Type 2 diabetes, no longer make up the majority of hospitalized COVID-19 patients, unlike in the early stages of the pandemic.
Availability of Antiviral Medication: The antiviral medication Paxlovid is now accessible and has been shown to prevent hospitalization in COVID-19 cases.
Increased Immunity: A significant proportion of Americans, approximately 95% according to the CDC, have some level of protective immunity against the virus, either through vaccination, prior infection, or both.
Dr. Joshua Denson, director of medical critical care at Tulane University School of Medicine, noted, “It seems that even with the new variants, the virus is not affecting this population as severely as it did before.”
COVID-19 patients who are currently hospitalized often have weakened immune systems, such as older adults, certain cancer patients, and organ transplant recipients. Dr. Ken Lyn-Kew, a pulmonologist at National Jewish Health in Denver, stated that almost all patients he has seen in the ICU over the last six months are immunosuppressed in some way.
Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University Medical Center, explained, “These are individuals who did not respond optimally to the vaccine or whose protection has waned since their last dose.”
Patients hospitalized with COVID-19 typically require assistance with breathing, according to Dr. Bernard Camins, medical director for infection prevention at the Mount Sinai Health System in New York City.
Looking ahead, Dr. Schaffner expects another increase in COVID-19-related hospitalizations during the winter, although he believes it will be less severe than previous years. He stated, “We don’t anticipate a scenario resembling the levels we experienced last year or the year before.”
