The official information disseminated since the beginning of the global health emergency due to the new coronavirus (now called SARS-CoV-2) already counted the data of deaths, and what is the incidence of death by population group: age and comorbidities (presence of secondary diseases). Mortality of the new coronavirus increases progressively with age; however, no deaths are recorded in very young people under 9 years of age. In addition, we also know that people with respiratory diseases or a depressed immune system are at greater risk of suffering serious complications or even death.
Now, a comprehensive study published in The Lancet provides a much more complete and detailed picture of the risk factors for dying from VIDOC-19. This is the first time that a complete picture of the disease's progression has been obtained.
The results were obtained from a sample of 191 patients; of these, 137 were discharged and 54 died in the hospital.
The conditions described in the study are as follows:
-Being an elderly person
-Showing signs of sepsis or septicemia
-Presenting a generalized infection
-Have clotting problems or blood circulation problems when you are admitted to the hospital
-In addition, the authors note two technical factors that may help physicians identify patients with a poor prognosis from the early stages: having a high value in the evaluation of sequential organ failure (SOFA) and a D-dimer (a coagulation marker) greater than 1 μg/L.
Evolution of COVID-19
The average duration of the fever was approximately 12 days, in both those who survived and those who died. With regard to coughing, 45% of the survivors still had it when they were discharged.
As for dyspnea (difficulty in breathing), it ceased after approximately 13 days but lasted until death in those who died.
In severe cases, lower lymphocyte counts (a type of white blood cell), elevated levels of interleukin-6 (IL-6, a bioindicator for inflammation and chronic disease), and increased concentrations of high-sensitivity troponin I (a marker of heart attack) were also common in severe COVID-19 disease.
The frequency of complications such as respiratory failure (98%, 53/54 non-survivors versus 36%, 50/137 survivors), sepsis (100%, 54/54 versus 42%, 58/137) and secondary infections (50%, 27/54 versus 1%, 1/137) were also higher in the deceased than in the patients who survived.
New data on the spread of the virus
The study also presents hitherto unknown data on the spread of the virus. The average duration of its release is 20 days in the survivors (a minimum of 8 and a maximum of 37 days). In addition, the virus was detected up to the time of death of the 54 who did not survive.
The results presented may help guide decisions about precautions to be taken during isolation and treatment.
Reference: Fei Zhou, Bin Cao et al. "Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study". The Lancet, 9 March 2020.