People who have the new coronavirus are most likely to die if they are older or show signs of sepsis or blood clotting problems. That’s according to a study that followed a small group of people infected with the covid-19 virus from diagnosis to hospital discharge or death.
Early on in the outbreak, two hospitals in Wuhan, China, were designated to treat people infected with the coronavirus. Until 1 February, people who were diagnosed with the virus in other hospitals in the city were transferred to one of the two for care.
By 31 January, 191 adults had been treated for the virus and either discharged or died at the two hospitals. Bin Cao at the China-Japan Friendship Hospital and Capital Medical University in Beijing and his colleagues assessed these cases, looking for patterns in the characteristics of those who survived the virus and those who didn’t.
The average age of these individuals was 56, and 62 per cent were men. Around half of those treated had underlying medical conditions, most commonly diabetes and high blood pressure.
Of the 191 individuals, 137 were eventually discharged and 54 died. The average time from the onset of the illness to discharge from hospital was 22 days, the team say. Those who didn’t survive the virus died an average of 18.5 days after symptoms began.
Death was more likely in people who already had diabetes or coronary heart disease. Older people were more likely to die, as were those showing signs of sepsis or blood clotting problems. Overall, more than half of those hospitalised with the virus developed sepsis.
“Poorer outcomes in older people may be due, in part, to the age-related weakening of the immune system and increased inflammation that could promote viral replication and more prolonged responses to inflammation, causing lasting damage to the heart, brain and other organs,” said study co-author Zhibo Liu at Jinyintan Hospital in Wuhan.
The team also found that people with covid-19 continue to shed the virus, and so might be able to infect others, for around 20 days, or until they die. “The extended viral shedding noted in our study has important implications for guiding decisions around isolation precautions and antiviral treatment in patients with confirmed covid-19,” said Cao.
Journal reference: The Lancet, DOI: 10.1016/ S0140-6736(20)30566-3