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Clinical characteristics of 82 cases of death from COVID-19
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Abstract
A recently developed pneumonia caused by SARS-CoV-2 bursting in Wuhan, China, has quickly spread across the world.We report the clinical characteristics of 82 cases of death from COVID-19 in a single center.Clinical data on 82 death cases laboratory-confirmed as SARS-CoV-2 infection were obtained from a Wuhan local hospital's electronic medical records according to previously designed standardized data collection forms.All patients were local residents of Wuhan, and a large proportion of them were diagnosed with severe illness when admitted.Due to the overwhelming of our system, a total of 14 patients (17.1%) were treated in the ICU, 83% of deaths never received Critical Care Support, only 40% had mechanical ventilation support despite 100% needing oxygen and the leading cause of death being pulmonary.Most of the patients who died were male (65.9%).More than half of the patients who died were older than 60 years (80.5%), and the median age was 72.5 years.The bulk of the patients who died had comorbidities (76.8%), including hypertension (56.1%), heart disease (20.7%), diabetes (18.3%), cerebrovascular disease (12.2%), and cancer (7.3%).Respiratory failure remained the leading cause of death (69.5%), followed by sepsis/MOF (28.0%), cardiac failure (14.6%), hemorrhage (6.1%), and renal failure (3.7%).Furthermore, respiratory, cardiac, hemorrhagic, hepatic, and renal damage were found in 100%, 89%, 80.5%, 78.0%, and 31.7% of patients, respectively.On admission, lymphopenia (89.2%), neutrophilia (74.3%), and thrombocytopenia (24.3%) were usually observed.Most patients had a high neutrophil-to-lymphocyte ratio of >5 (94.5%), high systemic immune-inflammation index of >500 (89.2%), and increased C-reactive protein (100%), lactate dehydrogenase (93.2%), and D-dimer (97.1%) levels.A high level of IL-6 (>10 pg/ml) was observed in all detected patients.The median time from initial symptoms to death was 15 days (IQR 11-20), and a significant association between aspartate aminotransferase (p = 0.002), alanine aminotransferase (p = 0.037) and time from initial symptoms to death was remarkably observed.Older males with comorbidities are more likely to develop severe disease and even die from SARS-CoV-2 infection.Respiratory failure is the main cause of COVID-19, but the virus itself and cytokine release syndrome-mediated damage to other organs, including cardiac, renal, hepatic, and hemorrhagic damage, should be taken seriously as well.
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Self-citation
Metadata
- Authors
- Zhang, B., Zhou, X., Qiu, Y., Song, Y., Feng, F., Feng, J., Song, Q., Jia, Q., & Wang, J.
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2020-07-09
- Volume
- 15
- Issue
- 7
- Pages
- e0235458
- ISSN
- 1932-6203 (ISSN-L)
- OpenAlex
- W3041206342
- Cited by
- 683
- References
- 12
- FWCI
- 18.98
- Type
- journal article
- Language
- en
- Open access
- gold
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