A study published in Lancet reveals that older age, higher Sequential Organ Failure Assessment (SOFA) score and elevated d-dimer at admission are risk factors for death in adults with COVID-19.
In this large two-centre retrospective cohort study of Chinese inpatients with a laboratory-confirmed diagnosis of COVID-19 captured, the average age was 56 years (range 18-87), 62 per cent of whom were male. Of 191 patients, 137 were discharged and 54 died.
Comorbidity was present in 48 per cent of patients, with hypertension (30%), diabetes (19%) and coronary heart disease (8%) being the most common.
Common symptoms upon admission were fever and cough, followed by sputum production and fatigue. Lymphocytopaenia occurred in 40 per cent of patients. Ninety-five per cent of patients received antibiotics and 21 per cent received antivirals (lopinavir/ritonavir).
Median time from illness onset to discharge was 22 days and to death was 18.5 days. Invasive mechanical ventilation was required in 32 patients, 97 per cent of whom died.
Sepsis was the most common complication, followed by respiratory failure, ARDS, heart failure and septic shock.
Multivariable regression showed increased odds of in-hospital death associated with older age, higher SOFA score, and d-dimer >1µg/L on admission.