Fatality risk factors from Covid-19 identified in Wuhan patients

Patient

Canberra,March 10,2020 (dpa/NAN) According to a new study published on Tuesday  hospitalised patients who were old, showed signs of sepsis and had blood- clotting issues were more likely to have died due to Covid-19 in China’s Wuhan,

Wuhan is the epicentre of the novel coronavirus epidemic,

The researchers were looking for the first time  factors that are associated with a higher risk of death due to the disease and worked with 191 adult patients with the virus in two hospitals in Wuhan between Dec. 29 and Jan 31.

The study published on Tuesday in The Lancet journal is observational, therefore cannot prove cause and effect, the researchers said, adding it is a good start to finding out those most at risk.

The deadly virus originated in the Chinese city of Wuhan in December and has spread across the globe, with more than 110,000 cases confirmed worldwide and more than 4,000 fatalities.

In China alone, 3,136 people have died from Covid-19.

In the study of 191 Wuhan patients, 137 were discharged and 54 died in hospital.

Specifically, being of an older age, having a high risk of organ failure, and having a significant blood clot (thrombus) formation are the factors that could help clinicians to identify patients with poor prognosis at an early stage, the study said.

“Older age, showing signs of sepsis on admission, underlying diseases like high blood pressure and diabetes, and the prolonged use of non-invasive ventilation were important factors in the deaths of these patients,” said the study’s co-author Zhibo Liu from Jinyintan Hospital, China.

He said older people may suffer worse results due to, in part, the weak immune system because of old age, increased inflammation that could promote viral replication and more prolonged responses to inflammation, causing lasting damage to the major organs.

In the study, 91 of the 191 patients had comorbidity, with most common hypertension (30 per cent), followed by diabetes (19 per cent) and coronary heart disease (8 per cent).

Patients who died were on average 69 years old, while patients who survived were on average 52 years old, according to the study.

Fifty-three out of 54 non-survivors had respiratory failure, while only 36 per cent of survivors had them.

All of the non-survivors had sepsis, but only 42 per cent of survivors had them.

Covid-19 inpatients shed the virus for longer than expected with the median duration of 20 days in survivors, ranging from eight to 37 days, while the virus was detectable until death in the 54 non-survivors.

Prolonged viral shedding could mean that patients are capable of continuing to spread Covid-19, though the duration of viral shedding influenced by disease severity.

The researchers warned that the true duration of viral shedding for all patients’ remains unclear due to the severe illness of those studied and limited samples and genetic material for testing.

The study’s co-lead author Prof. Bin Cao said the extended viral shedding has important implications for guiding decisions around isolation precautions and antiviral treatment in patients with confirmed Covid-19 infection.

“However, we need to be clear that viral shedding time should not be confused with other self-isolation guidance for people who may have been exposed to Covid-19 but do not have symptoms, as this guidance is based on the incubation time of the virus,” he said.

The study found the median duration of fever due to the virus was about 12 days in both survivors and non-survivors, but the cough lasted a while, 45 per cent of survivors  were still coughing on discharge.

In survivors, shortness of breath ceased after about 13 days, but would last until death in non-survivors.(dpa/NAN)

HS/MZA

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Edited by Halima Sheji/Maharazu Ahmed