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Rural COVID-19 ICU patients have ‘higher risk of dying’ says West Virginia University study

Kentucky Hospital Association

Dr. Sunil Sharma, chief of pulmonary critical care and sleep medicine at West Virginia University, said the Mountain State ran out of ICU beds twice during COVID-19 surges. 

Sharma led a study that looked at the mortality rates of rural COVID-19 patients admitted to intensive care units. The study found that rural ICU patients have a greater chance of dying than ICU patients in urban areas. 

Of 81 patients, 54% died within 30 days of being admitted to an ICU. Compared to urban areas where that number is 30%. 

Sharma said there are many reasons why the outcomes are so different. 

“We have reduced access to care, which is pretty apparent, because these are far flung areas, sometimes they have to drive for several hours to you and get medical attention,” Sharma said.

Rural populations tend to be older and have higher rates of diabetes, obesity and hypertension, which predisposes them to be sicker, Sharma said.

Credit WVU Photo/Zane Lacko
Dr. Sunil Sharma, chief of pulmonary critical care and sleep medicine at West Virginia University

Critical access hospitals aren’t designed to care for long-term intensive care unit stays. CAHs  are small — 25 beds or less — and are at least 35 miles from another hospital. 

About 51 of the 81 patients also had to be ventilated because of “acute respiratory distress syndrome from COVID-19,” according to the study’s news release. Sharma said the condition requires specialized care. 

“The critical access hospitals were just not designed for that — they don’t have any intensive care physicians, they don’t have logistical support for that.”

The rural patients were transferred to ICUs in larger hospitals. But COVID-19 case surges complicated that process. 

“Because of unavailability of beds, we ended up having these patients staying in those units and suffering some devastating consequences or being transferred too late,” Sharma said. 

He added, “We as a community are probably the least vaccinated. So I think it’s a double whammy.”

But Sharma is hopeful that the study will be impactful because the research is local to West Virginia. 

“This is not a distant information that something happened in China or in Europe. This is their community,” Sharma said.  “And if they see this devastation, there’s more likelihood that they will think in a more positive way that ‘I think we need to get vaccinated.’”

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