000			04034nam a22004817a 4500
001			D0001C000051
003			DOH
005			20201120150514.0
008			201120b ||||| |||| 00| 0 eng d
245	0	0	_aClinical characteristics of 113 deceased patients with coronavirus disease 2019 : _bretrospective study / _cTao Chen [and nineteen others]
520	3		_aObjective: To delineate the clinical characteristics of patients with coronavirus disease 2019 (covid-19) who died. Design: Retrospective case series. Setting: Tongji Hospital in Wuhan, China. Participants: Among a cohort of 799 patients, 113 who died and 161 who recovered with a diagnosis of covid-19 were analysed. Data were collected until 28 February 2020. Main outcome measures: Clinical characteristics and laboratory findings were obtained from electronic medical records with data collection forms. Results: The median age of deceased patients (68 years) was significantly older than recovered patients (51 years). Male sex was more predominant in deceased patients (83; 73%) than in recovered patients (88; 55%). Chronic hypertension and other cardiovascular comorbidities were more frequent among deceased patients (54 (48%) and 16 (14%)) than recovered patients (39 (24%) and 7 (4%)). Dyspnoea, chest tightness, and disorder of consciousness were more common in deceased patients (70 (62%), 55 (49%), and 25 (22%)) than in recovered patients (50 (31%), 48 (30%), and 1 (1%)). The median time from disease onset to death in deceased patients was 16 (interquartile range 12.0-20.0) days. Leukocytosis was present in 56 (50%) patients who died and 6 (4%) who recovered, and lymphopenia was present in 103 (91%) and 76 (47%) respectively. Concentrations of alanine aminotransferase, aspartate aminotransferase, creatinine, creatine kinase, lactate dehydrogenase, cardiac troponin I, N-terminal pro-brain natriuretic peptide, and D-dimer were markedly higher in deceased patients than in recovered patients. Common complications observed more frequently in deceased patients included acute respiratory distress syndrome (113; 100%), type I respiratory failure (18/35; 51%), sepsis (113; 100%), acute cardiac injury (72/94; 77%), heart failure (41/83; 49%), alkalosis (14/35; 40%), hyperkalaemia (42; 37%), acute kidney injury (28; 25%), and hypoxic encephalopathy (23; 20%). Patients with cardiovascular comorbidity were more likely to develop cardiac complications. Regardless of history of cardiovascular disease, acute cardiac injury and heart failure were more common in deceased patients. Conclusion: Severe acute respiratory syndrome coronavirus 2 infection can cause both pulmonary and systemic inflammation, leading to multi-organ dysfunction in patients at high risk. Acute respiratory distress syndrome and respiratory failure, sepsis, acute cardiac injury, and heart failure were the most common critical complications during exacerbation of covid-19.
580			_aIn: BMJ 2020 Mar 26;368:m1091. doi: 10.1136/bmj.m1091
650		2	_aCoronavirus Infections _xcomplications
650		2	_aCoronavirus Infections _xdiagnosis
650		2	_aCoronavirus Infections _xdrug therapy
650		2	_aCoronavirus Infections _xmortality
650		2	_aCoronavirus Infections _xtherapy
650		2	_aPandemics
650		2	_aPneumonia, Viral _xcomplications
700	1		_aChen, Tao
700	1		_aWu, Di
700	1		_aChen, Huilong
700	1		_aYan, Weiming
700	1		_aYang, Danlei
700	1		_aChen, Guang
700	1		_aMa , Ke
700	1		_a Xu, Dong
700	1		_aYu, Haijing
700	1		_aWang, Hongwu
700	1		_aWang, Tao
700	1		_aGuo, Wei
700	1		_aChen, Jia
700	1		_aDing, Chen
700	1		_aZhang, Xiaoping
700	1		_aHuang, Jiaquan
700	1		_aHan, Meifang
700	1		_aLi, Shusheng
700	1		_aLuo, Xiaoping
700	1		_aZhao, Jianping
700	1		_aNing, Qin
856			_uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190011/
942			_cCV
999			_c1784 _d1784