Hospitalization and Critical Care of 109 Decedents with COVID-19 Pneumonia in Wuhan, China

Du, Ronghui; Liu, Limin; Yin, Wen; Wang, Wen; Guan, Lulu; Yuan, Mingli; Li, Yu-Lei; Hu, Yi; Li, Xuyan; Sun, Bing; Peng, Peng; Shi, Honglei

doi:10.1513/annalsats.202003-225oc

Cited by 188 publications

(259 citation statements)

References 13 publications

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“…In the later stages of the disease, majority of patients (98.8%) died with pulmonary and extrapulmonary organ damage. Major critical complications during hospitalization included respiratory failure or ARDS, acute cardiac injury, sepsis, acute kidney injury and septic shock in our study, which is slightly different from those reported in recent studies 7,8,11 .…”

Section: Discussioncontrasting

confidence: 99%

“…In detail, we found that 96.1% of fatal cases had hypoalbuminema, which has been proven to be associated with mortality in critical patients 19 . Lymphocytopenia occurred in more than 70% of patients in our study, a finding that was consistent with the results of recent reports 6,7,10,11,14,15 . About 64.7% of patients with COVID-19 had increased increased D-dimer levels.…”

Section: Discussionsupporting

confidence: 94%

“…Nevertheless, the 20% of fatal cases less than 60 yeas old can not be ignored, the death cause by COVID-19 might occurred in any age. Additionally, more than 60% of the fatal cases infected by COVID-19 had chronic underlying diseases, mainly hypertension, diabetes, coronary heart disease, and renal insufficiency, which is also in line with previous studies 7,8,10,11 . Although co-morbidities are risk factors for poor outcome, we observed 59 cases (36.4%) who had died without any co-morbidity.…”

Section: Discussionsupporting

confidence: 90%

“…These laboratory abnormalities are similar to those previously observed in patients with SARS-CoV-2 infection [6][7][8][9][10][11][14][15][16][17][18] . In detail, we found that 96.1% of fatal cases had hypoalbuminema, which has been proven to be associated with mortality in critical patients 19 .…”

Section: Discussionsupporting

confidence: 88%

“…The elderly and males who are vulnerable population of deaths caused by SARS-CoV-2 infection have been noted in some studies [6][7][8][9][10][11][12] . In our study, we observed a greater number of men than women in the fatal cases with SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 98%

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Clinical features of 162 fatal cases of COVID-19: a multi-center, retrospective study

Zhou

Ding

Qing³

et al. 2020

Preprint

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Understanding the epidemiological and clinical characteristics of fatal cases infected with SARS-CoV-2 is import to develop appropriate preventable intervention programs in hospitals. Demographic data, clinical symptoms, clinical course, co-morbidities, laboratory findings, CT scans, treatments and complications of 162 fatal cases were retrieved from electric medical records in 5 hospitals of Wuhan, China. The median age was 69.5 years old (IQR: 63.0-77.25; range: 29-96). 112 (69.1%) cases were men. Hypertension (45.1%) was the most common co-morbidity, but 59 (36.4%) cases had no co-morbidity. At admission, 131 (81.9%) cases were assessed as severe or critical. However, 39 (18.1%) were assessed as moderate. Moderate cases had a higher prevalence of hypertension and chronic lung disease comparing with severe or critical cases (P<0.05, respectively). 126 (77.8%) and 132 (81.5%) cases received antiviral treatment and glucocorticoids, respectively. 116 (71.6%) cases were admitted to ICU and 137 (85.1%) cases received mechanical ventilation. Respiratory failure or acute respiratory distress syndrome (93.2%) was the most common complication. The young cases of COVID-19, without co-morbidity and in a moderate condition at admission could develop fatal outcome. We need to be more cautious in case management of COVID-19 for preventing the fatal outcomes.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 98%

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Clinical features of 162 fatal cases of COVID-19: a multi-center, retrospective study

Zhou

Ding

Qing³

et al. 2020

Preprint

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Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy

et al. 2020

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IMPORTANCE Many patients with coronavirus disease 2019 (COVID-19) are critically ill and require care in the intensive care unit (ICU). OBJECTIVE To evaluate the independent risk factors associated with mortality of patients with COVID-19 requiring treatment in ICUs in the Lombardy region of Italy. DESIGN, SETTING, AND PARTICIPANTS This retrospective, observational cohort study included 3988 consecutive critically ill patients with laboratory-confirmed COVID-19 referred for ICU admission to the coordinating center (Fondazione IRCCS [Istituto di Ricovero e Cura a Carattere Scientifico] Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy) of the COVID-19 Lombardy ICU Network from February 20 to April 22, 2020. Infection with severe acute respiratory syndrome coronavirus 2 was confirmed by real-time reverse transcriptase-polymerase chain reaction assay of nasopharyngeal swabs. Follow-up was completed on May 30, 2020. EXPOSURES Baseline characteristics, comorbidities, long-term medications, and ventilatory support at ICU admission. MAIN OUTCOMES AND MEASURES Time to death in days from ICU admission to hospital discharge. The independent risk factors associated with mortality were evaluated with a multivariable Cox proportional hazards regression. RESULTS Of the 3988 patients included in this cohort study, the median age was 63 (interquartile range [IQR] 56-69) years; 3188 (79.9%; 95% CI, 78.7%-81.1%) were men, and 1998 of 3300 (60.5%; 95% CI, 58.9%-62.2%) had at least 1 comorbidity. At ICU admission, 2929 patients (87.3%; 95% CI, 86.1%-88.4%) required invasive mechanical ventilation (IMV). The median follow-up was 44 (95% CI, 40-47; IQR, 11-69; range, 0-100) days; median time from symptoms onset to ICU admission was 10 (95% CI, 9-10; IQR, 6-14) days; median length of ICU stay was 12 (95% CI, 12-13; IQR, 6-21) days; and median length of IMV was 10 (95% CI, 10-11; IQR, 6-17) days. Cumulative observation time was 164 305 patient-days. Hospital and ICU mortality rates were 12 (95% CI, 11-12) and 27 (95% CI, 26-29) per 1000 patients-days, respectively. In the subgroup of the first 1715 patients, as of May 30, 2020, 865 (50.4%) had been discharged from the ICU, 836 (48.7%) had died in the ICU, and 14 (0.8%) were still in the ICU; overall, 915 patients (53.4%) died in the hospital. Independent risk factors associated with mortality included older age (hazard ratio [HR], 1.75; 95% CI, 1.60-1.92), male sex (HR, 1.57; 95% CI, 1.31-1.88), high fraction of inspired oxygen (FiO 2) (HR, 1.14; 95% CI, 1.10-1.19), high positive end-expiratory pressure (HR, 1.04; 95% CI, 1.01-1.06) or low PaO 2 :FiO 2 ratio (HR, 0.80; 95% CI, 0.74-0.87) on ICU admission, and history of chronic obstructive pulmonary disease (HR, 1.68; 95% CI, 1.28-2.19), hypercholesterolemia (HR, 1.25; 95% CI, 1.02-1.52), and type 2 diabetes (HR, 1.18; 95% CI, 1.01-1.39). No medication was independently associated with mortality (angiotensin-converting enzyme inhibitors HR, 1.17; 95% CI, 0.97-1.42; angiotensin receptor blockers HR, 1.05; 95% CI, 0.85-1.29). CONCLUS...

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Central nervous system manifestations in COVID‐19 patients: A systematic review and meta‐analysis

et al. 2021

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Background At the end of December 2019, a novel respiratory infection, initially reported in China, known as COVID‐19 initially reported in China, and later known as COVID‐19, led to a global pandemic. Despite many studies reporting respiratory infections as the primary manifestations of this illness, an increasing number of investigations have focused on the central nervous system (CNS) manifestations in COVID‐19. In this study, we aimed to evaluate the CNS presentations in COVID‐19 patients in an attempt to identify the common CNS features and provide a better overview to tackle this new pandemic. Methods In this systematic review and meta‐analysis, we searched PubMed, Web of Science, Ovid, EMBASE, Scopus, and Google Scholar. Included studies were publications that reported the CNS features between 1 January 2020 and 20 April 2020. The data of selected studies were screened and extracted independently by four reviewers. Extracted data analyzed by using STATA statistical software. The study protocol registered with PROSPERO (CRD42020184456). Results Of 2,353 retrieved studies, we selected 64 studies with 11,687 patients after screening. Most of the studies were conducted in China (58 studies). The most common CNS symptom of COVID‐19 was headache (8.69%, 95%CI: 6.76%–10.82%), dizziness (5.94%, 95%CI: 3.66%–8.22%), and impaired consciousness (1.90%, 95%CI: 1.0%–2.79%). Conclusions The growing number of studies has reported COVID‐19, CNS presentations as remarkable manifestations that happen. Hence, understanding the CNS characteristics of COVID‐19 can help us for better diagnosis and ultimately prevention of worse outcomes.

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Hospitalization and Critical Care of 109 Decedents with COVID-19 Pneumonia in Wuhan, China

Cited by 188 publications

References 13 publications

Clinical features of 162 fatal cases of COVID-19: a multi-center, retrospective study

Clinical features of 162 fatal cases of COVID-19: a multi-center, retrospective study

Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy

Central nervous system manifestations in COVID‐19 patients: A systematic review and meta‐analysis

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