Analysis on clinical features of death patients with COVID-19: a retrospective, single-center study from Wuhan, China

Abstract

Background An ongoing global pandemic of pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused thousands of deaths in China since December, 2019. We aimed to describe the clinical course of patients died of SARS-CoV-2 infection.Methods In this retrospective study, we reviewed 194 patients with SARS-CoV-2 infection, who died consecutively between Feb 3 to 24, 2020 in Tongji Hospital (Wuhan, China). Basic demographic and clinical information, laboratory findings, complications and treatments were extracted from electronic medical records of Hospital Information System. Unpaired t test was employed to evaluate the statistical differences of the serum level of high-sensitive cardiac troponin I (hs-cTnI) among different age or sex groups. The relationship between hs-cTnI and inflammatory cytokines were estimated using Spearman correlation analysis.Results The death patients aged 69.62 ± 10.98, in which 68.6% were male. 74.7% patients had underlying chronic illnesses. The most common symptoms were fever (83%), cough (69.3%), and dyspnea (65.6%). Decreased lymphocyte count (91.4%), elevated level of hs-cTnI (82.9%) and inflammatory parameters in serum were commonly seen. The hs-cTnI level was significantly higher in the group aged 60–79 and male patients. A week positive correlation was observed between hs-cTnI values and D-dimer values (r = 0.343, p༜0.05). Acute respiratory distress syndrome was the main complication. Assisted respiration, antimicrobial drugs, glucocorticoids and immune globulin were the major treatments.Conclusion Most non-survivors with SARS-CoV-2 infection were old with chronic illnesses, complicated by multiple organ dysfunction. Prevention is better than cure in high-risk population.

Association Between Elevated High Sensitivity Cardiac-Troponin I Levels and Increase in Levels of C-Reactive Protein, Interleukin-6, D-Dimer, and Consequent Cardiac Injury and Mortality for Patients With Coronavirus Disease 2019: A Meta-Analysis

“…Oxidative stress, which is featured by raised production of reactive oxygen species and free radicals succeeded by lowered serum total antioxidant concentrations, can clarify usual incidence of coagulopathy in intense COVID-19 [30,32]. Yao et al (2020) declared that ill individuals in male group and 60-79 years age groups incline to generate raised hs-cTn I levels than female and other age groups, which was in agreement with all raised percent of aged male deceased [5].…”

“…Interleukin-6 (IL-6) stimulates production of C-RP [4]. D-dimer (DD) is a soluble fibrin decaying output that comes from ordered collapse of thrombi by coagulative and fibrinolytic system [5]. Higher concentrations of circulating DD are existent in circumstances related to thrombosis [6].…”

“…Elevated IL-6 concentrations were recognized among deceased cases from COVID-19 in comparison with survived cases[39] Yao et al (2020). administered that there was considerable association between atypical hs-cTn I levels and DD concentrations[5]. About half of affected individuals with COVID-19 have raised DD concentrations, which is correlated with illness gravity and elevated death averages[42].…”

“…This known as CS may speedily result in single or multiple organ dysfunction syndromes (MODS) and is identified to specify not only acuteness but also predicting COVID-19 progression[41]. Elevated IL-6 concentrations were recognized among deceased cases from COVID-19 in comparison with survived cases[39] Yao et al (2020). administered that there was considerable association between atypical hs-cTn I levels and DD concentrations[5].…”