Clinical characteristics of 101 COVID-19 nonsurvivors in Wuhan, China: a retrospective study

  1. Qiao Shi
  2. Kailiang Zhao
  3. Jia Yu
  4. Fang Jiang
  5. Jiarui Feng
  6. Kaiping Zhao
  7. Xiaoyi Zhang
  8. Xiaoyan Chen
  9. Peng Hu
  10. Yupu Hong
  11. Man Li
  12. Fang Liu
  13. Chen Chen
  14. Weixing Wang

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Abstract

Background

The outbreak of COVID-19 has aroused global concerns. We aimed to describe the clinical characteristics of COVID-19 nonsurvivors and analyze possible causes for the rapid disease progress to death.

Methods

Patients with confirmed COVID-19 died in Renmin Hospital of Wuhan University before February 15, 2020, were identified. We obtained epidemiological, demographic, and clinical data from electronic medical records.

Results

Among 101 nonsurvivors, the median age was 71.0 years (IQR, 59.0-80.0), 59.4% were male, 79.2% had one or more comorbidities including hypertension (58.4%), cardiovascular disease (22.8%), diabetes (20.8%) etc. The most common symptoms were fever (76.2%), cough (58.4%) and dyspnea (54.5%). Respiratory failure (99.0%), acute cardiac injury (52.5%), sepsis (40.6%) and acute kidney injury (23.8%) were most common complications. Compared with patients died after 3 days of admission, patients died within 3 days of admission had significantly higher white blood cell count (10.8 vs 6.7×10 9 /L, P =0.001) and neutrophil count (8.9 vs 5.5×10 9 /L, P =0.001), longer prothrombin time (13.2 vs 12.5 s, P =0.040), higher D-dimer concentration (7.64 vs 2.82, P =0.040), higher lactate level (2.9 vs 2.2 mmol/L, P =0.042), lower oxygen saturation (85.0% vs 91.0%, P =0.008), and were more likely to suffer sepsis (52.1% vs 30.2%, P =0.025).

Conclusions

Older patients with underlying comorbidities suffering COVID-19 were at high risk of death. Respiratory failure, acute cardiac injury and acute kidney injury played crucial roles in the death of COVID-19 patients. Early development of sepsis was associated with the rapid disease progress to death.

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  1. ScreenIT

    SciScore for 10.1101/2020.03.04.20031039: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All statistical analyses were performed using SPSS (version 22.0) and GraphPad Prism (version 5.0) software.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.03.04.20031039 on medRxiv