Clinical characteristics of 101 non-surviving hospitalized patients with COVID-19: A single center, retrospective study

ABSTRACT OBJECTIVE To study the clinical characteristics of non-surviving hospitalized patients with confirmed COVID-19 in Wuhan, China, and tracked the causes of the death. DESIGN Retrospective case series. SETTING Two campus of Renmin Hospital of Wuhan University in Wuhan, China, and is responsible for the treatments for COVID-19 assigned by the government PARTICIPANTS 101 non-surviving hospitalized patients with confirmed COVID-19. Data were collected from 1 January 2020 to 15 February 2020. MAIN OUTCOME MEASURES Clinical data were collected using a standardized case report form. If information was not clear, the investigators in Wuhan contacted the doctor responsible for treating the patients or family members of non-survivors for clarification. RESULTS Of 121 died patients with confirmed COVID-19, 101 cases with relatively complete medical records were included. The median age of the 101 non-survivors were 71 years (IQR, 59-80), 60 (59.41%) were men. 82 (81.19%) had fever, 82 (81.19%) had 1 or more comorbidities including hypertension (59 [58.42%]) and diabetes (22 [21.78%]) etc. The median course from hospitalization to death was 4d (IQR, 2-7d). Of 101 died patients, 100 (99.01%) suffered respiratory failure, 53 (52.48%) developed acute myocardial injury, acute kidney and liver injury occurred in 23 (22.77%) and 18 (17.82%) patients, respectively. Chest computed tomographic scans of non-survivors showed vast and fused ground-glass shadows. Compared to patients who survived 3 days, no statistical difference was noticed on lung severity score (11.91 vs 12.07) in patients who died within 3 days. Furthermore, significant elevated laboratory indicators including hypersensitive troponin (1.98 vs 0.2ng/ml), blood urea nitrogen (15.20 vs 10.08mmol/l), neutrophil count (11.23 vs 6.48 *109/L), procalcitonin (2.26 vs 0.58ng/ml) and lactic acid (3.80 vs 2.62 mmol/l) etc. were noted in patients who died with 3 days while PaO2 (54.75 vs 67.45mmHg), CD3% (51.57 vs 60.43%) and CD8% (16.42 vs 23.42%) were significantly depressed. CONCLUSION Older patients (>70 years) with comorbidities had a steeply increased risk of death when they suffered COVID-19. Besides respiratory failure, acute cardiac and kidney damage or failure, secondary to COVID-19, played a crucial role in causing death of patients.