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Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study

Our take —

Patients who died of COVID-19 had significantly lower oxygen saturation and higher C-reactive protein concentrations at admission relative to those who survived. As seen in previous studies, older age and presence of underlying conditions and morbidities were associated with death.

Study design

Case Series

Study population and setting

109 inpatients who died with laboratory-confirmed SARS-CoV-2 infection and 116 infected inpatients who recovered treated in two hospitals in Wuhan, China from January 1, 2020 to February 21, 2020.

Summary of Main Findings

Patients who died were older and had more medical comorbidities, on average, than those who recovered. Patients who died presented to hospital later than those who recovered (median of 10 days after illness onset versus median of 7 days). Patients who died exhibited a higher white blood cell count but a lower lymphocyte count and lymphocyte percentage. At admission, patients who died had significantly lower oxygen saturation (85% vs. 97%) and far higher C-reactive protein concentrations (109.25 mg/L vs. 3.22 mg/L) compared to those who recovered. C-reactive protein levels remained high throughout the treatment course in those who died but decreased with treatment in those who recovered.

Study Strengths

This is one of the largest analyses to date assessing factors associated with death in severely ill SARS-CoV-2 infected patients

Limitations

There is little discussion of how these patients were specifically selected from the broader population of COVID-19 patients. Multivariable analysis would be appropriate to parse the relevance and importance of many interrelated factors. The lack of such analyses makes interpretation of individual presenting factors for prognostic or therapeutic purposes difficult.

Value added

This study adds detail relevant to broader investigations of prognostic markers for severe disease and death, and reinforces existing knowledge. Oxygen saturation levels are a promising marker, since they can be measured quickly and easily upon admission.