Clinical Features of 85 Fatal Cases of COVID-19 from Wuhan A Retrospective Observational Study
Clinical Features of 85 Fatal Cases of COVID-19 from Wuhan A Retrospective Observational Study
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DOI：
10.1164/rccm.202003-0543oc
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发表时间：
2020-06-01
影响因子：
24.7
通讯作者：
Xu, Guogang
中科院分区：
文献类型：
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作者：
Du, Yingzhen;Tu, Lei;Xu, Guogang
理由：截至2020年5月12日，全球死于冠状病毒病(新冠肺炎)病毒的人数超过28.6万人。死亡的危险因素被归因于高龄和合并症，但尚未得到准确的定义。目的：报告武汉市两所医院85例新冠肺炎死亡病例的临床特征。方法：收集2020年1月9日至2020年2月15日期间85例新冠肺炎死亡病例的病历资料。记录的信息包括病史、接触史、合并症、症状、体征、实验室检查、计算机断层扫描和临床处理。测量和主要结果：患者的中位年龄为65.8岁，其中72.9%是男性。常见症状为发热78例(91.8%)、气短50例(58.8%)、乏力50例(58.8%)、呼吸困难60例(70.6%)。高血压、糖尿病和冠心病是最常见的并存疾病。值得注意的是，81.2%的患者入院时嗜酸性粒细胞计数非常低。并发症包括呼吸衰竭80例(94.1%)、休克69例(81.2%)、急性呼吸窘迫综合征63例(74.1%)、心律失常51例(60%)等。大多数患者接受了抗生素治疗(77例[90.6%])、抗病毒治疗(78例[91.8%])和糖皮质激素治疗(65例[76.5%])。静脉注射丙种球蛋白38例(447%)，静脉注射干扰素u2b 33例(38.8%)。结论：本次新冠肺炎死亡病例描述性研究中，多数病例为50岁以上男性慢性非传染性疾病患者。大多数患者死于多器官功能衰竭。早期出现呼吸急促可作为新冠肺炎急性加重的观察症状。嗜酸性粒细胞减少可能预示预后不良。联合应用抗菌药物对这组患者的预后并没有太大的好处。
Rationale: The global death toll from coronavirus disease (COVID-19) virus as of May 12, 2020, exceeds 286,000. The risk factors for death were attributed to advanced age and comorbidities but have not been accurately defined.Objectives: To report the clinical features of 85 fatal cases of COVID-19 in two hospitals in Wuhan.Methods: Medical records were collected of 85 fatal cases of COVID-19 between January 9, 2020, and February 15, 2020. Information recorded included medical history, exposure history, comorbidities, symptoms, signs, laboratory findings, computed tomographic 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%]), and dyspnea (60 [70.6%]). Hypertension, diabetes, and coronary heart disease were the most common comorbidities. Notably, 81.2% of patients had very low eosinophil counts on admission. Complications included respiratory failure (80 [94.1%]), shock (69 [81.2%]), acute respiratory distress syndrome (63 [74.1%]), and arrhythmia (51 [60%]), among others. Most patients received antibiotic (77 [90.6%1), antiviral (78 [91.8%]), and glucocorticoid (65 [76.5%]) treatments. A total of 38 (447%) and 33 (38.8%) patients received intravenous immunoglobulin and IFN-u2b, respectively.Conclusions: In this depictive study of 85 fatal cases of COVID-19, most cases were males aged over 50 years 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. A combination of antimicrobial drugs did not offer considerable benefit to the outcome of this group of patients.