Retrospective Analysis of Clinical Features in 101 Death Cases with COVID-19

Abstract

Background

In December 2019, viral pneumonia outbreaks caused by the novel coronavirus occurred in Wuhan, China, and spread rapidly worldwide, the illness progress of coronavirus disease 2019(COVID-19) in partial patients is rapid and the mortality rate is relatively high. The present study aims to describe the clinical features in the death cases with COVID-19.

Methods

In this single center and observational study, we recruited 101 death cases with COVID-19 from Dec 30, 2019 to Feb 16, 2020 in Intensive Care Unit (ICU) of Wuhan Jinyintan Hospital. Demographics, underlying diseases, X-ray/CT images, possible therapy strategies and test results were collected and analyzed on patients admission to the ICU and 48 hours before deaths.

Findings

Of 101 COVID-19 dead cases, 47 patients went directly to the ICU because of critical condition, and 54 patients were transferred to ICU with aggravated condition. Over fifty six percent (56.4%) of patients were laboratory confirmed by RT-PCR, and 43.6% were consistent with clinical diagnostic criteria.Among them, 64 were males and 37 were females, with average age of 65.46 years (SD 9.74). Interestingly, all deaths shwed significant difference in blood type distribution, with 44.44% of type A, 29.29% of type B, 8.08% of type AB, and 18.19% of type O.The clinical manifestations of the novel coronavirus pneumonia are non-specific,the common symptoms included fever (91,,90.10%), cough (69,68.32%) and dyspnea (75,74.26%). Neutrophils, procalcitonin(PCT),C-reactive protein(CRP),and interleukin-6(IL-6), D-dimer gradually increased with progress of the disease. Myocardial enzymes were abnormal in most patients at admission, myocardial damage indicators were significantly increased. Sixty one (60.40%) patients were given antiviral drugs, 59(58.42%),received glucocorticoids, 63.37% were given intravenous immunoglobulins, and 44.55% were treated with thymosin preparations. All patients received antibiotic treatment, 63(62.38%) were given restricted antibiotics, 23(22.78%) were administrated to antifungal drugs. Non-invasive ventilator or high-flow oxygen therapy were given in 84(83.17%) patients, and invasive mechanical ventilation was used in 76.24% patients. The median time from acute respiratory distress syndrome(ARDS) to invasive mechanical ventilation was 3.00 days(IQR 0.00-6.00). The duration of invasive mechanical ventilation was 5 days (IQR2.00-8.00).

Interpretation

Critical COVID-19 can cause fatal respiratory distress syndrome and multiple organ failure with high mortality. The blood group distribution of the deaths remarkably differred from that of Han population in Wuhan.Heart may be the earliest damaged organ except the lungs. Hospital-acquired pneumonia(HAP) in the later period is worthy of attention.

Funding

Supported by “the Fundamental Research Funds for the Central Universities (WK9110000037)”.

SciScore for 10.1101/2020.03.09.20033068: (What is this?)

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

Table 1: Rigor

Institutional Review Board Statement	IRB: This study has been approved by the Ethics Committee of Wuhan Jinyintan Hospital (KY-2020-28.01), and all relevant personnel exempts from informed consent due to the particularity of the disease outbreak. 2.2. Data Collection: The retrospective analysis was based on the case reports, nursing records, test results, and imaging results. Consent: This study has been approved by the Ethics Committee of Wuhan Jinyintan Hospital (KY-2020-28.01), and all relevant personnel exempts from informed consent due to the particularity of the disease outbreak. 2.2. Data Collection: The retrospective analysis was based on the case reports, nursing records, test results, and imaging results.
Randomization	not detected.
Blinding	not detected.
Power Analysis	not detected.
Sex as a biological variable	not detected.

Table 2: Resources

Software and Algorithms
Sentences	Resources
SPSS (version 24.0) was used for all analyses.	SPSS suggested: (SPSS, RRID:SCR_002865)

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: We detected the following sentences addressing limitations in the study:

This study has some limitations. Only the critical death patients are included, and no comparison was made between the improvement groups. The sample size can be increased in further research for prospective case-control study. The blood group composition of patients cannot be statistically analyzed and whether the blood group difference is related to the susceptibility of COVID-19 infection needs to be clarified.

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.

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