Clinical characteristics of 101 COVID-19 nonsurvivors in Wuhan, China: a retrospective study

Background The outbreak of COVID-19 has aroused global concerns. We aimed to describe the clinical characteristics of COVID-19 nonsurvivors and analyze possible causes for the rapid disease progress to death. Methods Patients with confirmed COVID-19 died in Renmin Hospital of Wuhan University before February 15, 2020, were identified. We obtained epidemiological, demographic, and clinical data from electronic medical records. Results Among 101 nonsurvivors, the median age was 71.0 years (IQR, 59.0-80.0), 59.4% were male, 79.2% had one or more comorbidities including hypertension (58.4%), cardiovascular disease (22.8%), diabetes (20.8%) etc. The most common symptoms were fever (76.2%), cough (58.4%) and dyspnea (54.5%). Respiratory failure (99.0%), acute cardiac injury (52.5%), sepsis (40.6%) and acute kidney injury (23.8%) were most common complications. Compared with patients died after 3 days of admission, patients died within 3 days of admission had significantly higher white blood cell count (10.8 vs 6.7×10 9 /L, P =0.001) and neutrophil count (8.9 vs 5.5×10 9 /L, P =0.001), longer prothrombin time (13.2 vs 12.5 s, P =0.040), higher D-dimer concentration (7.64 vs 2.82, P =0.040), higher lactate level (2.9 vs 2.2 mmol/L, P =0.042), lower oxygen saturation (85.0% vs 91.0%, P =0.008), and were more likely to suffer sepsis (52.1% vs 30.2%, P =0.025). Conclusions Older patients with underlying comorbidities suffering COVID-19 were at high risk of death. Respiratory failure, acute cardiac injury and acute kidney injury played crucial roles in the death of COVID-19 patients. Early development of sepsis was associated with the rapid disease progress to death.