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25 maart 2020

Clinical course and mortality risk of severe COVID-19 - JAMA

Bron: 17-03-2020 https://doi.org/10.1016/S0140-6736(20)30566-3

Aim
Comment, summary of previous publications on the first COVID-19 patients, indicating the severity of hospitalized COVID-19. 

Summary

  • Fei Zhou et al (Lancet): 191 hospitalized patients in Wuhan.
    • Median age 56 (IQR 46-67), 65% men, 48% with comorbidities.
    • In survivors throat swabs were PCR positive for a median of 20·0 days (17·0–24·0), but the virus was detectable until death in non-survivors.
    • 137 discharged, 54 death
    • In-hospital death was associated with older age, a higher Sequential Organ Failure Assessment score, blood d-dimer higher than 1ug/mL and findinfs known to be associated with severe pneumonia. 
    • In hospital mortality very high in patients requiring invasive mechanical ventilation (31/32, 97%)
  • Yang et al(Lancet Resp Med): 
    • Morality 62% among critically ill patients and 81% among those requiring mechanical ventilation