Clinical course and mortality risk of severe COVID-19

• Published in: The Lancet (British edition) Vol. 395; no. 10229; pp. 1014 - 1015
• Main Authors: Weiss, Paul, Murdoch, David R
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 28.03.2020; Elsevier Limited
• Subjects: Adult; Betacoronavirus; China; Comment; Coronavirus Infections - mortality; Coronaviruses; COVID-19; Dimers; Epidemics; Fatalities; Health risks; Humans; Inpatients; Mechanical ventilation; Mortality; Mortality - trends; Mortality risk; Pandemics; Patients; Pneumonia; Pneumonia, Viral; Retrospective Studies; Risk analysis; Risk Factors; SARS-CoV-2; Ventilation; Ventilators; China
• ISSN: 0140-6736; 1474-547X; 1474-547X
• DOI: 10.1016/S0140-6736(20)30633-4

In-hospital death was associated with, on admission, older age (odds ratio 1·10, 95% CI 1·03–1·17; p=0·0043), a higher Sequential Organ Failure Assessment score (5·65, 2·61–12·23; p<0·0001), and blood d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033), findings known to be associated with severe pneumonia.6,7 The study also presents early data on changes in clinical and laboratory findings over time, which could help clinicians to identify patients who progress to more severe disease. In-hospital mortality was high (28%), much higher than in other reports that had incomplete follow-up data,3,5,8 and was very high among the 32 patients requiring invasive mechanical ventilation, of whom 31 (97%) died. By identifying this large group of patients united by their disease and tracking them to these endpoints, the authors have provided us with insight into risk factors for in-hospital death.