Abstract

BackgroundThe 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.MethodsIn 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.ResultsThe 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.ConclusionsElderly 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.

Highlights

  • The treatment of critically ill patients with COVID-19 who were hospitalized in Wuhan has been reported

  • As the only designated center for the treatment of COVID-19 patients with critical illness in Tianmen City, as of March 6, 2020, a total of 415 SARS-CoV-2-positive patients had been admitted to the First People’s Hospital of Tianmen, and all 14 deaths from COVID-19 in this city occurred at the hospital

  • We reported that the casefatality rate (CFR) of COVID-19 in Tianmen was much higher than that in core cities in the early stage of the pandemic [5]

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Summary

Introduction

The treatment of critically ill patients with COVID-19 who were hospitalized in Wuhan has been reported. The clinical characteristics of patients who died of COVID-19 in regions with relatively scarce healthcare resources remain unknown. Previous studies have described the clinical characteristics, diagnosis and treatment processes, and outcomes of patients with COVID19 who were hospitalized in major cities [3, 4]. The characterization of critically ill patients and nonsurvivors in areas with relatively scarce healthcare resources remains unknown. As the only designated center for the treatment of COVID-19 patients with critical illness in Tianmen City, as of March 6, 2020, a total of 415 SARS-CoV-2-positive patients had been admitted to the First People’s Hospital of Tianmen, and all 14 deaths from COVID-19 in this city occurred at the hospital. To facilitate the scientific diagnosis and treatment of COVID-19 patients with critical illness globally, we retrospectively investigated and analyzed the medical records of 14 patients who died of COVID-19 during hospitalization at our hospital

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