Analysis of Clinical Features of 11 Death Cases Caused by COVID⁃19/ 新型冠状病毒肺炎死亡患者11例临床特征分析

Objective To investigate clinical characteristics of 11 fatalities from coronavirus disease 2019 (COVID-19) in a bid to improve the recognition of early diagnosis and treatment in critical patients Methods Clinical information of 110 COVID⁃19 patients who were discharged from Hubei No 3 People’s Hospital of Jiang⁃han University from January 24, 2020 to February 19，2020 was collected They were divided into the survival group and the death group Clinical characteristics and laboratory indices in the two groups were retrospectively analyzed Results Of the 110 patients, 44 males（40%） and 66 females（60%）, there was a nonsignificant difference in gender between the death and survival groups The average age in the nonsurvival group was 72 4 years, significantly higher than that in the survival group，of 54 6 years（P < 0 001） With respect to the clinical type on admission，severe patients accounted for 36 4% in the death group and 11 1 % in the survival group，with a significant difference between the two groups And 45 5% of patients in the death group were suffering from one or even more than two types of complications such as hypertension，diabetes and heart diseases Compared with those in the survival group，patients in the death group presented more pronounced symptoms on admission，encompassing dry cough（100 0%），chest distress（81 8%）and dyspnea（63 6%） The rapid progression in these patients ultimately escalated into ARDS（100%），acute cardiac injury（41 7%）and multiple organ failure（58 3% The degree of decreased lymphocyte count on admission varied somewhat between the two groups The death group presented higher degrees of increases in white blood cell count 11 4 × 109/L（IQR：9 8 ~ 12 5）and neutrophil count11 0 × 109/L（IQR：9 4 ~ 11 7）than the survival group，with statistically significant differences There were significant differences in SAA，PCT，CRP and D⁃dimer between the two groups Patients in the death group had already revealed hepatic and renal dysfunction and myocardial damage on admission，presenting significantly higher levels of AST，γ⁃GGT，BUN，LDH and NT⁃proBNP than those in the survival group（P < 0 001） Conclusion COVID⁃19 fatalities were predominantly severe patients aged over 60 years with underlying diseases such as hypertension，diabetes and heart diseases The resulting acute lung injury and acute myocardial damage from inflammatory cytokine storm during the course of the disease can be the critical causes of sudden deterioration and death Routine blood parameters，SAA，CRP，PCT，myocardial enzymes, NT⁃proBNP and blood coagulation indices after admission presented prognostic effects in the early stage of COVID⁃19