InA study of 85 fatal cases of COVID-19 in Wuhan found most cases were male aged over 50 years old with noncommunicable chronic diseases. The combination of anti-microbial drugs did not offer considerable benefit to the outcome of this group of patients.
The majority of the patients died of multiple organ failure. Early onset of shortness of breath may be used as an observational symptom for COVID-19 exacerbations. Eosinophilopenia may indicate a poor prognosis. T
The study by researchers at the American Thoracic Society is the biggest yet on coronavirus patient deaths.
Researchers from China and the US analysed the electronic health records of patients with COVID-19 who died despite treatment at Hanan Hospital and Wuhan Union Hospital between 9 January and 15 February. The researchers analysed information on the patients' medical histories, exposures to coronavirus, additional chronic diseases they had, symptoms, laboratory findings, CAT scan results and clinical management.
Four in five patients had very low counts of eosinophils – cells that are reduced in severe respiratory infections – on admission. The report says the median age of the patients was 65.8, and 72.9% were men. Their most common symptoms were fever, shortness of breath and fatigue. Hypertension, diabetes and coronary heart disease were the most common comorbidities. They said abnormally low levels of eosinophils in the blood may indicate a poor prognosis, and the early onset of shortness of breath may be used as an observational symptom for COVID-19.
Abstract
Background: The global death toll from COVID-19 virus exceeds 21000. The risk factors for death were attributed to advanced age and co-morbidities, but haven't been accurately defined.
Objectives: To report the clinical features of 85 fatal cases with COVID-19 in two hospitals in Wuhan.
Method: Medical records of 85 fatal cases of COVID-19 between January 9 and February 15, 2020 were collected. Information recorded included medical history, exposure history, comorbidities, symptoms, laboratory findings, CT scans and clinical management.
Measurements and Main Results: The median age of the patients was 65.8 years and 72.9% were male. Common symptoms were fever (78 [91.8%]), shortness of breath (50 [58.8%]), fatigue (50 [58.8%]), dyspnea (60 [70.6%]). Hypertension, diabetes and coronary heart disease were the most common comorbidities. Notably, 81.2% patients had very low eosinophil counts at admission. Complications included respiratory failure (80 [94.1%]), shock (69 [81.2%]), ARDS (63 [74.1%]), arrhythmia (51 [60%]), etc. Most patients received antibiotic (77 [90.6%]), antiviral (78 [91.8%]) and glucocorticoids (65 [76.5%]) treatments. 38 patients [44.7%] and 33 [38.8%] received intravenous immunoglobulin and interferon α2b respectively.
Conclusions: In this depictive study of 85 fatal cases of COVID-19, most cases were male aged over 50 years old with noncommunicable chronic diseases. The majority of the patients died of multiple organ failure. Early onset of shortness of breath may be used as an observational symptom for COVID-19 exacerbations. Eosinophilopenia may indicate a poor prognosis. The combination of anti-microbial drugs did not offer considerable benefit to the outcome of this group of patients.
Authors
Yingzhen Du, Lei Tu, Pingjun Zhu, Mi Mu, Runsheng Wang, Pengcheng Yang, Xi Wang, Chao Hu, Rongyu Ping, Peng Hu, Tianzhi Li, Feng Cao, Christopher Chang, Qinyong Hu, Yang Jin, Guogang Xu
[link url="https://www.timeslive.co.za/news/sci-tech/2020-04-04-this-is-who-is-most-likely-to-die-from-covid-19-wuhan-researchers/"]Full report in The Times[/link]
[link url="https://www.atsjournals.org/doi/abs/10.1164/rccm.202003-0543OC"]American Journal of Respiratory and Critical Care Medicine[/link]