Clinical Features of 85 Fatal Cases of COVID-19 from Wuhan: A Retrospective Observational Study

Abstract

Background: The global death toll from COVID-19 virus exceeds 21000. The risk factors for death were attributed to advanced age and co-morbidities, but haven't been accurately defined. Objectives: To report the clinical features of 85 fatal cases with COVID-19 in two hospitals in Wuhan. Method: Medical records of 85 fatal cases of COVID-19 between January 9 and February 15, 2020 were collected. Information recorded included medical history, exposure history, comorbidities, symptoms, laboratory findings, CT scans and clinical management. Measurements and Main Results: The median age of the patients was 65.8 years and 72.9% were male. Common symptoms were fever (78 [91.8%]), shortness of breath (50 [58.8%]), fatigue (50 [58.8%]), dyspnea (60 [70.6%]). Hypertension, diabetes and coronary heart disease were the most common comorbidities. Notably, 81.2% patients had very low eosinophil counts at admission. Complications included respiratory failure (80 [94.1%]), shock (69 [81.2%]), ARDS (63 [74.1%]), arrhythmia (51 [60%]), etc. Most patients received antibiotic (77 [90.6%]), antiviral (78 [91.8%]) and glucocorticoids (65 [76.5%]) treatments. 38 patients [44.7%] and 33 [38.8%] received intravenous immunoglobulin and interferon α2b respectively. Conclusions: In this depictive study of 85 fatal cases of COVID-19, most cases were male aged over 50 years old with noncommunicable chronic diseases. The majority of the patients died of multiple organ failure. Early onset of shortness of breath may be used as an observational symptom for COVID-19 exacerbations. Eosinophilopenia may indicate a poor prognosis. The combination of anti-microbial drugs did not offer considerable benefit to the outcome of this group of patients. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)