Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study
By Tao Chen, Di Wu, Huilong Chen, Weiming Yan, Danlei Yang, Guang Chen, K. Ma, Dong Xu, Hai-jing Yu, Hongwu Wang and 11 more. British medical journal, 2020
3,814 citations recorded by the source corpus.
Abstract Objective To delineate the clinical characteristics of patients with coronavirus disease 2019 (covid-19) who died. Design Retrospective case series. Setting Tongji Hospital in Wuhan, China. Participants Among a cohort of 799 patients, 113 who died and 161 who recovered with a diagnosis of covid-19 were analysed. Data were collected until 28 February 2020. Main outcome measures Clinical characteristics and laboratory findings were obtained from electronic medical records with data collection forms. Results The median age of deceased patients (68 years) was significantly older than recovered patients (51 years). Male sex was more predominant in deceased patients (83; 73%) than in recovered patients (88; 55%). Chronic hypertension and other cardiovascular comorbidities were more frequent among deceased patients (54 (48%) and 16 (14%)) than recovered patients (39 (24%) and 7 (4%)). Dyspnoea, chest tightness, and disorder of consciousness were more common in deceased patients (70 (62%), 55 (49%), and 25 (22%)) than in recovered patients (50 (31%), 48 (30%), and 1 (1%)). The median time from disease onset to death in deceased patients was 16 (interquartile range 12.0-20.0) days. Leukocytosis was present in 56 (50%) patients who died and 6 (4%) who recovered, and lymphopenia was present in 103 (91%) and 76 (47%) respectively. Concentrations of alanine aminotransferase, aspartate aminotransferase, creatinine, creatine kinase, lactate dehydrogenase, cardiac troponin I, N-terminal pro-brain natriuretic peptide, and D-dimer were markedly higher in deceased patients than in recovered patients. Common complications observed more frequently in deceased patients included acute respiratory distress syndrome (113; 100%), type I respiratory failure (18/35; 51%), sepsis (113; 100%), acute cardiac injury (72/94; 77%), heart failure (41/83; 49%), alkalosis (14/35; 40%), hyperkalaemia (42; 37%), acute kidney injury (28; 25%), and hypoxic encephalopathy (23; 20%). Patients with cardiovascular comorbidity were more likely to develop cardiac complications. Regardless of history of cardiovascular disease, acute cardiac injury and heart failure were more common in deceased patients. Conclusion Severe acute respiratory syndrome coronavirus 2 infection can cause both pulmonary and systemic inflammation, leading to multi-organ dysfunction in patients at high risk. Acute respiratory distress syndrome and respiratory failure, sepsis, acute cardiac injury, and heart failure were the most common critical complications during exacerbation of covid-19.
Subfields: Infectious Diseases, Molecular Biology, Neurology
View Paper: https://www.semanticscholar.org/paper/b70a8480363d0f8694c792acf36ee66a8937d82a
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Citations in the corpus
- Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19 (2020, result): “were also observed in patients with COVID-19 on admission [88].”
- Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms (2020, neutral): “A retrospective report of COVID-19 patients from Wuhan described encephalopathy, or persistent (> 24 h) alterations in consciousness, in roughly one-fifth of individuals succumbing to the disease (Chen et al., 2020).”
- Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations (2020, neutral): “Interestingly, the prevalence of non-survivors was also higher in diabetic subjects with COVID-19 and it varied from 22 to 31% in different studies [17,21,23,24,27].”
- Cardiovascular complications in COVID-19 (2020, positive): “Prior viral illnesses, including Middle East respiratory syndrome coronavirus (MERS-CoV), have been associated with myocardial injury and myocarditis with troponin elevation, thought to be due to increased cardiac physiologic stress, hypoxia, or direct myocardial injury [4, [24] [25] [26] [27] [28] ”
- Postmortem examination of COVID‐19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings in lungs and other organs suggesting vascular dysfunction (2020, result): “Comorbidities in our cohort correspond with clinical observational studies.(27,28) Other interesting characteristics of our group included a striking predominance of males and a higher incidence of blood group A.”
- Biomarkers associated with COVID-19 disease progression (2020, background): “observed in a cohort of 799 patients (113 non-survivors and 161 recovered) markedly higher concentrations of ALT, AST, creatinine, CK, LDH, cardiac troponin I, N-terminal pro-brain natriuretic peptide, and D-dimer in non-survivors compared to recovered patients [62].”