NEW YORK — Most COVID-19 patients present mild and moderate symptoms, but severe cases lead to death. As the death toll from the coronavirus continues to rise, it’s important that we find the common risk factors for death from the disease. A new study identifies the clinical features of patients who died in Wuhan, China towards the beginning of the outbreak.
A team of researchers from China and the U.S. analyzed the health records of 85 patients who died from COVID-19 between January 9th and February 15th, 2020. All 85 patients were receiving treatment in hospitals before they passed away. The statistical analyses include the medical records, recorded information on their medical histories, exposures to coronavirus, comorbidities, symptoms, laboratory findings, CT scan results and clinical management of these 85 patients.
The analyses reveal some interesting things about these patients. The median age of those infected was 66, and 73% of them were men. Prevalent symptoms upon hospitalization were fever, shortness of breath and fatigue. CT scans reveal that almost all patients had pneumonia. The most common comorbidities were diabetes, high blood pressure and coronary heart disease.
Researchers also say that common complications from the coronavirus include shock, acute respiratory distress syndrome, respiratory failure and cardiac arrhythmia. The most frequent treatments patients received included antibiotics, antivirals and steroid treatments, and some patients received immunoglobulin or interferon alpha-2b via IV.
“The effectiveness of medications such as antivirals or immunosuppressive agents against COVID-19 is not completely known,” the authors note in a statement to the American Thoracic Society. “Perhaps our most significant observation is that while respiratory symptoms may not develop until a week after presentation, once they do there can be a rapid decline, as indicated by the short duration between time of admission and death (6.35 days on average) in our study.”
Researchers note that more than 80% of the coronavirus patients were exhibiting a unique characteristic upon admission to the hospitals. They had very low counts of eosinophils, a type of white blood cell that plays a key role in the immune response. It seems like a low count of eosinophils indicates a bad prognosis for patients.
“Our study, which investigated patients from Wuhan, China who died in the early phases of this pandemic, identified certain characteristics. As the disease has spread to other regions, the observations from these areas may be the same, or different. Genetics may play a role in the response to the infection, and the course of the pandemic may change as the virus mutates as well,” the authors conclude. “Since this is a new pandemic that is constantly shifting, we think the medical community needs to keep an open mind as more and more studies are conducted.”
The study is published in The American Journal of Respiratory and Critical Care Medicine.