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Writer's pictureAbderrahim Benmoussa, phD

Clinical features associated with fatality, a retrospective cohort study

Quality of evidence: C

 

Clinical characteristics of 113 deceased patients with coronavirus disease 2019: a retrospective study

 

Authors: Chen T et al

Journal: The British Medical Journal

Objectives: Find determinant of fatality

Strength of evidence: Low (retrospective study, monocentric, descriptive, detailed)

Methods/publication type:

  • Retrospective cohort study

  • 799 patients, analyze on 113 deceased vs 161 survivors

  • 13 Janvier au 12 février 2020

Highlights :

General observations:

  • Deceased are older ( 68 vs 51 in controls), more often males (73% vs 55%), have comorbidities (63% vs 39%) including hypertension (48% vs 24%), cardiovascular disease (14% vs 4%) and cerebrovascular disease (4% vs none)

  • Symptoms to admission longer for deceased (10 vs 9 days)

Clinical and biological markers:

  • Symptoms:

  • comparable rates of fever and cough, higher rates of dyspnea (62% vs 31%), thoracic pressure (49% vs 22%), consciousness disorder (22% vs 1%)

  • Higher arterial pressure (SAP = 37 mmHg vs 125 mmHg), higher pulse rate (101 vs 91) and respiration frequency (24 vs 20),

  • Higher Leukocytosis (50% vs 4%), more occurrence of lymphopenia (39% vs 5%)

  • More liver and kidney function disruptions, higher inflammatory syndrome and more occurrence of bilateral frosted glass opacity and sub-segmental consolidation on chest imaging

  • Complications:

  • ARDS (100%), sepsis (100%), acute heart injury (77%), cardiac arrest (49%), alkalosis (40%), hyperKalemia (37%), acute kidney injury (25%), hypoxic encephalopathy (20%)

  • Probable secondary bacterial infection (high Procalcitone levels) and shock

  • Some cases of acute kidney injury, hypoxic encephalopathy

  • Rare cases of DIC and acute liver injury

 

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