The official information released, since the global health emergency due to the new coronavirus (now called SARS-CoV-2) began, already counted the data of deaths, and what is the incidence of death by population group: age and comorbidities (presence of secondary diseases). The mortality of the new coronavirus increases progressively with age; On the other hand, there are no deaths in very young people, under 9 years of age. In addition, we also know that people with respiratory diseases or a depressed immune system are at higher risk of serious complications or even death.
Now, a comprehensive study published in The Lancet magazine offers a much more complete and detailed view of the risk factors for dying from COVID-19. This is the first time that a complete picture of disease progression has been obtained.
The results have been obtained from a sample of 191 patients; of them, 137 were discharged and 54 died in the hospital.
Risk factor’s
The conditions described in the study are as follows:
- Being an elderly person
- Show signs of sepsis or septicemia
- Have a generalized infection
- Having clotting problems or blood circulation problems when admitted to the hospital.
In addition, the authors point to two technical factors that could help clinicians identify patients with a poor prognosis early on: having a high Sequential Organ Failure Assessment (SOFA) score and a D-dimer (a coagulation marker). ) greater than 1 μg / L.
Evolution of COVID-19
The mean duration of fever was approximately 12 days, both in those who survived and in those who died. Regarding cough, 45% of the survivors still had it when they were discharged.
As for dyspnea (shortness of breath), it ceased after approximately 13 days, but lasted until death in those who died.
In severe cases, lower lymphocyte count (a type of white blood cell), elevated levels of interleukin 6 (IL-6, a bioindicator for inflammation and chronic disease), and increased troponin levels were also common. High sensitivity I (a marker of heart attack) were more frequent in severe COVID-19 disease.
The frequency of complications such as respiratory failure (98%, 53/54 non-survivors vs 36%, 50/137 yes), sepsis (100%, 54/54 vs 42%, 58/137) and secondary infections (50 %, 27/54 versus 1%, 1/137) were also higher in the deceased than in the patients who survived.
New data on the spread of the virus
The study also presents previously unknown data on the spread of the virus. The average duration of their release is 20 days in survivors (a minimum of 8 and a maximum of 37 days). In addition, the virus was detected until the death of the 54 who did not survive.
The results presented can help guide decisions about precautions during isolation and treatment.
Reference:
Fei Zhou, Bin Cao et al. “Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study”. The Lancet, March 9, 2020.
