Division of Nephrology, Renmin Hospital of Wuhan University, Hubei, China.
Division of Medical Services, The First People's Hospital of Tianmen, Tianmen, Hubei, China.
BMC Infect Dis. 2021 Jan 20;21(1):88. doi: 10.1186/s12879-021-05770-z.
The treatment of critically ill patients with COVID-19 who were hospitalized in Wuhan has been reported. However, the clinical characteristics of patients who died of COVID-19 in regions with relatively scarce healthcare resources remain unknown.
In this retrospective study, a total of 14 patients who were admitted from January 18 to February 11, 2020 and died of COVID-19 were evaluated. The epidemiological, symptomatic, laboratory, radiological and treatment records were reviewed and analyzed.
The mean age of the 14 patients was 56.7 (SD 15.3) years, and 8 (57.1%) were older than 50 years. Eight (57.1%) were men, and 11 (78.6%) had one or more high risk factors. The most common chronic diseases among these patients were cardiovascular disease (7, 50.0%), hypertension (6, 42.9%), and chronic kidney disease (5, 35.7%). General symptoms included cough (12, 85.7%), fever (11, 78.6%), and dyspnea (10, 71.4%). The median duration from the onset of symptoms to death was 11 (IQR 6.5-19.5) days, and the median duration from admission to death was 4.5 (1.0-11.8) days. Patients who died within 4.5 days had more severe pulmonary lesions, significantly reduced lymphocytes and elevated C-reactive protein (CRP). Most patients had organ dysfunction, including 13 (92.9%) with acute respiratory distress syndrome (ARDS), 4 (28.6%) with cardiac injury, 3 (21.4%) with acute kidney injury, and 3 (21.4%) with liver dysfunction.
Elderly SARS-CoV-2-infected patients with comorbidities, especially those with ARDS and severe chest CT findings on admission, are at increased risk of death and deserve special attention and quality medical treatment.
已有报道称，武汉对 COVID-19 重症住院患者进行了治疗。然而，在医疗资源相对匮乏的地区，死于 COVID-19 的患者的临床特征尚不清楚。
在这项回顾性研究中，共评估了 2020 年 1 月 18 日至 2 月 11 日期间入院并死于 COVID-19 的 14 名患者。回顾和分析了他们的流行病学、症状、实验室、影像学和治疗记录。
14 名患者的平均年龄为 56.7（标准差 15.3）岁，8 名（57.1%）患者年龄大于 50 岁。8 名（57.1%）为男性，11 名（78.6%）有一个或多个高危因素。这些患者最常见的慢性疾病是心血管疾病（7 例，50.0%）、高血压（6 例，42.9%）和慢性肾脏病（5 例，35.7%）。一般症状包括咳嗽（12 例，85.7%）、发热（11 例，78.6%）和呼吸困难（10 例，71.4%）。从症状出现到死亡的中位时间为 11（IQR 6.5-19.5）天，从入院到死亡的中位时间为 4.5（1.0-11.8）天。在 4.5 天内死亡的患者肺部病变更严重，淋巴细胞明显减少，C 反应蛋白（CRP）升高。大多数患者存在器官功能障碍，包括 13 例（92.9%）急性呼吸窘迫综合征（ARDS）、4 例（28.6%）心脏损伤、3 例（21.4%）急性肾损伤和 3 例（21.4%）肝功能障碍。
感染 SARS-CoV-2 的老年合并症患者，尤其是入院时 ARDS 和胸部 CT 严重表现的患者，死亡风险增加，需要特别关注和高质量的医疗。
