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Showing content from https://pubmed.ncbi.nlm.nih.gov/32171076/ below:

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Affiliations

• ¹ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
• ² Department of Tuberculosis and Respiratory Disease, Jinyintan Hospital, Wuhan, China.
• ³ Department of Pulmonary and Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, China.
• ⁴ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China.
• ⁵ Department of Clinical Laboratory, Jinyintan Hospital, Wuhan, China.
• ⁶ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; Department of Respiratory Medicine, Capital Medical University, Beijing, China.
• ⁷ GCP Center, Jinyintan Hospital, Wuhan, China.
• ⁸ Tsinghua University School of Medicine, Beijing, China.
• ⁹ Department of Tuberculosis and Respiratory Disease, Jinyintan Hospital, Wuhan, China. Electronic address: 2716637947@qq.com.
• ¹⁰ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China; Department of Respiratory Medicine, Capital Medical University, Beijing, China; Tsinghua University School of Medicine, Beijing, China. Electronic address: caobin_ben@163.com.

• PMID: 32171076
• PMCID: PMC7270627
• DOI: 10.1016/S0140-6736(20)30566-3

Item in Clipboard

Fei Zhou et al. Lancet. 2020.

• ¹ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
• ² Department of Tuberculosis and Respiratory Disease, Jinyintan Hospital, Wuhan, China.
• ³ Department of Pulmonary and Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, China.
• ⁴ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China.
• ⁵ Department of Clinical Laboratory, Jinyintan Hospital, Wuhan, China.
• ⁶ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; Department of Respiratory Medicine, Capital Medical University, Beijing, China.
• ⁷ GCP Center, Jinyintan Hospital, Wuhan, China.
• ⁸ Tsinghua University School of Medicine, Beijing, China.
• ⁹ Department of Tuberculosis and Respiratory Disease, Jinyintan Hospital, Wuhan, China. Electronic address: 2716637947@qq.com.
• ¹⁰ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China; Department of Respiratory Medicine, Capital Medical University, Beijing, China; Tsinghua University School of Medicine, Beijing, China. Electronic address: caobin_ben@163.com.

• PMID: 32171076
• PMCID: PMC7270627
• DOI: 10.1016/S0140-6736(20)30566-3

Item in Clipboard

• Department of Error.

  [No authors listed] [No authors listed] Lancet. 2020 Mar 28;395(10229):1038. doi: 10.1016/S0140-6736(20)30606-1. Epub 2020 Mar 12. Lancet. 2020. PMID: 32171424 Free PMC article. No abstract available.

• Department of Error.

  [No authors listed] [No authors listed] Lancet. 2020 Mar 28;395(10229):1038. doi: 10.1016/S0140-6736(20)30638-3. Epub 2020 Mar 17. Lancet. 2020. PMID: 32192581 Free PMC article. No abstract available.

Background: Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described.

Methods: In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death.

Findings: 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03-1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61-12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64-128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0-24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days.

Interpretation: The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.

Funding: Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Copyright © 2020 Elsevier Ltd. All rights reserved.

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Clinical courses of major symptoms…

Clinical courses of major symptoms and outcomes and duration of viral shedding from…

Clinical courses of major symptoms and outcomes and duration of viral shedding from illness onset in patients hospitalised with COVID-19 Figure shows median duration of symptoms and onset of complications and outcomes. ICU=intensive care unit. SARS-CoV-2=severe acute respiratory syndrome coronavirus 2. ARDS=acute respiratory distress syndrome. COVID-19=coronavirus disease 2019.

Temporal changes in laboratory markers…

Temporal changes in laboratory markers from illness onset in patients hospitalised with COVID-19…

Temporal changes in laboratory markers from illness onset in patients hospitalised with COVID-19 Figure shows temporal changes in d-dimer (A), lymphocytes (B), IL-6 (C), serum ferritin (D), high-sensitivity cardiac troponin I (E), and lactate dehydrogenase (F). Differences between survivors and non-survivors were significant for all timepoints shown, except for day 4 after illness onset for d-dimer, IL-6, and high-sensitivity cardiac troponin I. For serum ferritin (D), the median values after day 16 exceeded the upper limit of detection, as indicated by the dashed line. COVID-19=coronavirus disease 2019. IL-6=interleukin-6.

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