Wuhan ICU Reports 60 Percent Mortality in Its COVID-19 Patients

By Reuters Staff

March 25, 2020

NEW YORK (Reuters Health) - Mortality from COVID-19 exceeded 60% in critically ill patients in Wuhan, China, a retrospective study suggests.

Writing in The Lancet Respiratory Medicine, Dr. You Shang from Union Hospital, Tongji Medical College, Huazhong University of Science and Technology and colleagues report on 52 patients with confirmed COVID-19 who were admitted to the ICU at Wuhan Jin Yin-tan Hospital.

The mean age was 59.7 years, and 27 (52%) were older than 60 years. Overall, 21 (40%) had chronic diseases. None of the seven patients with a history of cerebrovascular diseases survived.

The most common presenting symptoms were fever (98%), cough (77%), and dyspnea (63.5%).

The median duration from onset of symptoms to radiological confirmation of pneumonia was five days, and the median duration from onset of symptoms to ICU admission was 9.5 days.

Most of these critically ill patients had organ function damage, including 35 (67%) with acute respiratory distress syndrome (ARDS), 15 (29%) with acute kidney injury, 12 (23%) with cardiac injury, 15 (29%) with liver dysfunction, and 1 (2%) with pneumothorax. Seven patients (13.5%) developed hospital-acquired infections.

Treatments included high-flow nasal cannula (63.5%), mechanical ventilation (71%), extracorporeal membrane oxygenation (11.5%), renal replacement therapy (17%), vasoconstrictive agents (35%), antiviral agents (44%), antibacterial agents (94%), and glucocorticoids (58%).

By day 28, 32 patients (61.5%) had died, with a median duration from ICU admission to death of seven days. Of the 20 patients who survived, 12 remained in hospital, including three who were still receiving invasive ventilation at 28 days.

Compared with survivors, non-survivors were older and were more likely to have chronic medical illnesses, to develop ARDS, and to receive mechanical ventilation.

Lymphocytopenia occurred in 44 patients (85%), with no significant difference between survivors and non-survivors.

"The severity of SARS-CoV-2 pneumonia poses great strain on critical care resources in hospitals, especially if they are not adequately staffed or resourced," the authors conclude.

Dr. Shang did not respond to a request for comments.

SOURCE: https://bit.ly/3apiAe9 Lancet Respiratory Medicine, online February 21, 2020.

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