Risk Factors for Death Among the First 80 543 Coronavirus Disease 2019 (COVID-19) Cases in China: Relationships Between Age, Underlying Disease, Case Severity, and Region

Abstract

Background Knowledge of COVID-19 epidemiology remains incomplete and crucial questions persist. We aimed to examine risk factors for COVID-19 death. Methods A total of 80 543 COVID-19 cases reported in China, nationwide, through April 8, 2020 were included. Risk factors for death were investigated by Cox proportional hazards regression and stratified analyses. Results Overall national case fatality ratio (CFR) was 5.64%. Risk factors for death were older age (≥80: adjusted hazard ratio [aHR]=12.58, 95% confidence interval [CI]=6.78-23.33), presence of underlying disease (aHR=1.33, CI=1.19-1.49), worse case severity (severe: aHR=3.86, CI=3.15-4.73; critical: aHR=11.34, CI=9.22-13.95), and near-epicenter region (Hubei: aHR=2.64, CI=2.11-3.30; Wuhan: aHR=6.35, CI=5.04-8.00). CFR increased from 0.35% (30-39 years) to 18.21% (≥70 years) without underlying disease. Regardless of age, CFR increased from 2.50% for no underlying disease to 7.72% for 1, 13.99% for 2, and 21.99% for ≥3. CFR increased with worse case severity from 2.80% (mild), to 12.51% (severe) and 48.60% (critical) regardless of region. Compared to other regions, CFR was much higher in Wuhan regardless of case severity (mild: 3.83% versus 0.14% in Hubei and 0.03% elsewhere; moderate: 4.60% versus 0.21% and 0.06%; severe: 15.92% versus 5.84% and 1.86%; and critical: 58.57% versus 49.80% and 18.39%). Conclusions Older patients regardless of underlying disease and patients with underlying disease regardless of age were at elevated risk of death. Higher death rates near the outbreak epicenter and during the surge of cases reflect the deleterious effects of allowing health systems to become overwhelmed.

Potential metal-related strategies for prevention and treatment of COVID-19

“…SARS-CoV-2, the coronavirus that causes COVID-19, has been proven to be highly contagious to all age groups, whereas most patients who showed symptoms are aged 40–69 (66.68%) [ 41 ]. Usually, patients older than 50 years old have a higher mortality rate after being infected [ 41 ].…”

“…SARS-CoV-2, the coronavirus that causes COVID-19, has been proven to be highly contagious to all age groups, whereas most patients who showed symptoms are aged 40–69 (66.68%) [ 41 ]. Usually, patients older than 50 years old have a higher mortality rate after being infected [ 41 ]. No matter if the infected person is symptomatic or asymptomatic, the person is contagious, making the primary source of the infection be virus-infected people [ 42 , 43 ].…”

SARS-CoV-2 vaccine safety and immunogenicity in patients with hematologic malignancies, transplantation, and cellular therapies

“…This is further compounded by therapies that can result in profound and prolonged immune dysfunction; therefore, worsening their immunocompromised state. Furthermore, the prevalence of hematologic malignancies rises with increasing age, which is independently associated with worse COVID-19 outcomes and diminished vaccine responses [ [5] , [6] , [7] ], as well as with a greater number of co-morbidities that may contribute additional COVID-19 risk [ 7 , 8 ].…”

Incidence of symptomatic Covid‐19 infections in patients with mastocytosis and chronic myeloid leukemia: A comparison with the general Austrian population

“…Soon later, a pandemic spreading of Covid‐19 was found and till today continues to strain healthcare systems globally 1,2 . The clinical course of the disease ranges from asymptomatic course or mild upper respiratory tract illness to severe viral pneumonia leading to respiratory failure or death due to acute respiratory distress syndrome (ARDS) or multi‐organ failure 2–8 . Most patients (>80%) present with mild or moderate symptoms and the majority of cases recover 8 .…”