There is a small but steady rise in the number of patients with COVID-19 admitted to Intensive Care Units (ICU) in hospitals in Chennai. Old age and co-morbidities are the main factors pushing up these admissions, say doctors. Many of these patients were also not vaccinated.
According to hospitalisation data in the daily bulletin issued by the Directorate of Public Health and Preventive Medicine, the number of ICU admissions have gradually risen from 82 on January 1 to 256 on January 13. Doctors across hospitals observed that only the elderly with co-morbidities were admitted to ICUs as of now. While some said there could be a mix of patients with Delta and Omicron variants in the ICU, which cannot be confirmed without sequencing of samples, a few pointed out that there were no significant findings of lung involvement in chest CT as of now.
S. Chandrasekar, professor and head, Department of Medicine, Government Stanley Medical College Hospital, said persons who were not vaccinated had more severe disease. “Age and multiple co-morbidities play a crucial role. Here, 80% of patients are aged above 60 and have uncontrolled co-morbidities such as diabetes, hypertension, renal ailments and cancer. They have a more severe form of disease,” he said.
While Omicron is known to cause mild disease, he said : “It has still not replaced Delta variant, which is in circulation. Given the rise in the number of cases, ICU admissions will be more. So, we are prepared and have strengthened the ICU team with recent management and triaging patients in the wards through a six-minute walk test to ascertain the severity of the disease and identify patients who are deteriorating early. All 19 patients in ICU admission now had significant elevation of C-Reactive Protein and D-Dimer on admission, which are immunological markers for severity of the disease.,” he said. One of the main reasons for steady rise in ICU admissions was co-morbidities, with diabetes, hypertension and obesity being the main ones, according to E. Theranirajan, dean of Rajiv Gandhi Government General Hospital. “Many of them are aged above 70 and are not vaccinated.,” he said. Of the 172 patients in admission, 19 were in the ICU. Some were seeking medical help late and there were instances of referrals from private hospitals as well. K. Narayanasamy, director of Government Corona Hospital, said the number of ICU admissions was slightly on the rise. At any given point of time, there are 10 to 15 patients in the ICU of the hospital. “Nevertheless, they required minimal oxygen of two to four litres. There are no young or middle-aged persons in the ICU. Age and co-morbidities are the key factors. We are admitting only those who require oxygen support and drugs,” he said.
“When compared to the second wave, the number of ICU admissions is less now. When we take overall hospitalisations, the number of persons requiring oxygen support and ventilatory support is very less when compared to the previous wave of Delta variant. So, there is a clear difference between Delta and Omicron variants on the severity of disease,” said R. Ebenezer, senior consultant and head, Critical Care Services Apollo Speciality Hospitals, Vanagaram.
It was the elderly with immuno-compromised conditions and not vaccinated who were becoming sicker now. “This is a small number. Omicron is rapidly replacing Delta variant,” he said and added that in the observation of radiologists, there was nil or minimal lung involvement found in chest CTs. “In the second wave, if we took 10 CTs, eight found lung involvement. This has almost reversed now. Almost every CT is negative for lung involvement or has minimal involvement,” he said.
Dr. Chandrasekar pointed out there was no significant findings in CT scans now.
