A first research result from China

A group of Chinese researchers conducted a cohort study of 191 patients in Wuhan, China. The aim was to identify the risk factors to die from COVID-19 and the characteristics of spread.
According to them this is the first study of Corona patients whose clinical results are known.
The study was published in The Lancet.

The cohort (n = 191) contained all recovered COVID-19 patients (n = 137) and died patients (n = 54)
from december 29 2019 to january 31 2020. This is the first population after the outbreak.
Statistical analysis (uni- and multivariable logistic regressionanalysis) was used to identify the riskfactors associalted with hospitaldeaths.
They also used clinical assessments like the SOFA-score (Sequential Organ Failure Assessment), labatory results and the spread of the virus (‘viral shedding’).

The average age of the whole cohort was 56 years (IQR 46-67), of those who died 69 years (IQR 63-76).
The median time from getting ill (before admission) to leaving the hospital was 22 days (IQR 18-25).
For those who died this time was 18.5 days.
32 people needed ventilation and 31 of them died.

Those who survived were contagious up to 20 days after start of the disease.  (IQR 17-24) The variation was large... from 8 days to 37 days.
Those who died were contageous until their death.

There was no significant difference between the survivors and those who died in time to symptoms of fever, cough, breathing difficulties, ARDS, IC-admission and the start with treatment of corticosteroids.

Death was best predicted by D dimer > 1 μg/mL,  a higher SOFA score at time of admission, and higher age.
These characteristics can be used to assess risk in new patients.


Source:
Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.  Fei Zhou, MD †, Ting Yu, MD †, Ronghui Du, MD †, Guohui Fan, MS †, Ying Liu, MD †, Zhibo Liu, MD †, et al.
Published:March 11, 2020DOI:https://doi.org/10.1016/S0140-6736(20)30566-3

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext


Review.

These results seemto show the failure of ventilation treatment. All persons but one died.
In fact this study shows nothing at all.
D-dimer is an accepted indicator of nearing death and a higher SOFA score means the person is already dealing with organ failure.

This study might back up the medical decision to make the choice for palliative care in these patients, but as we know absolutely nothing about the standard hospital care in this hospital no other conclusions can be drawn than that they have been measuring nearing death.
They wanted to assess risk factors for mortality, but they have measured early stages of mortality itself.