Researchers studying a cohort of COVID-19 fatalities in Wuhan, China found most patients who died were male, over age 50, with comorbidities such as hypertension, diabetes, coronary heart disease, and low blood eosinophil counts.
Notably, researchers observed these patients averaged less than a week between admission and death. “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,” they said.
The research, which was published online in the American Journal of Respiratory and Critical Care Medicine, studies the electronic health records of 85 COVID-19 patients who died between Jan 9 and Feb 15, 2020 after treatment at two Wuhan hospitals.
Some of the clinical characteristics of the patient fatalities included:
- 65.8 median age
- 72.9 % were men
- Most common symptoms: fever, dyspnea, and fatigue
- Most common comorbidities: hypertension, diabetes, and coronary heart disease
- 80%+ of patients had very low counts of eosinophils on admission
- Complications included: respiratory failure, shock, ARDS and cardiac arrhythmia
- Most patients received antibiotics, antivirals and glucocorticoids
- Some were given intravenous immunoglobulin or interferon alpha-2b
- The majority of patients studied died from multiple organ failure
Based on their findings, eosinophilopenia (abnormally low levels of eosinophils in the blood) may indicate a poor prognosis. The scientists also noted that the early onset of dyspnea may be used as an observational symptom for COVID-19 symptoms.
In addition, they noted that a combination of antimicrobial drugs (antivirals, antibiotics) did not significantly help these patients.
“The greatest number of deaths in our cohort were in males over 50 with non-communicable chronic diseases,” stated the authors. “We hope that this study conveys the seriousness of COVID-19 and emphasizes the risk groups of males over 50 with chronic comorbid conditions including hypertension, coronary heart disease and diabetes.”
“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. 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.”
Image credit: NIAID. Novel Coronavirus SARS-CoV-2. Transmission electron micrograph of SARS-CoV-2 virus particles, isolated from a patient. Image captured and color-enhanced at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland.