NEW #COVID19—First study identifies risk factors associated with death in adults hospitalised with new #coronavirus disease in 2 hospitals in Wuhan, China hubs.ly/H0nsfmD0 
Specifically, being of an older age, having a high Sequential Organ Failure Assessment (SOFA) score & having d-dimer greater than 1 μg/L are the factors that could help clinicians to identify #COVID19 patients with poor prognosis at an early stage
Study also suggests #COVID19 hospitalised patients shed the virus for longer than expected—median duration of viral shedding was 20 days in survivors & virus was detectable until death in the 54 non-survivors, but true duration of viral shedding for all patients remains unclear
The authors also caution that their study only included people with severe illness, and that there were limited samples and genetic material for testing
Fever duration was about 12 days in survivors (similar in non-survivors). But cough may last longer—45% of survivors had on discharge. In survivors, dyspnoea ceases after about 13 days but lasts until death in non-survivors. Study also shows occurrence of other complications
On average, patients were middle-aged (median age 56 years), most were men, & around half had underlying chronic conditions—most common being high blood pressure & diabetes. From illness onset, median time to discharge was 22 days & average time to death was 18.5 days
Compared with survivors, patients who died were more likely to be older (average age 69 y vs 52 y) & have a higher score on the Sequential Organ Failure Assessment (SOFA) indicating sepsis & elevated blood levels of d-dimer protein (marker for coagulation) on admission
Additionally, lower lymphocyte count, elevated levels of interleukin 6 (biomarker for inflammation and chronic disease), and increased high-sensitivity troponin I concentrations (a marker of heart attack) were more common in severe #COVID19 illness
Frequency of complications such as respiratory failure, sepsis, & secondary infections were also higher in those who died than survivors
Authors note their study gives a snapshot of early outbreak & might reflect more severe disease, plus not all tests were done in all patients so their risk factor role for death might be underestimated. Lack of treatments & appropriate care might have contributed to poor outcomes
Podcast 🎧 Listen to Asia Executive Editor of The Lancet, Helena Hui Wang, chat with author Bin Cao about his new paper describing the clinical course and risk factors for mortality of adult inpatients with #COVID19 in Wuhan, China⬇️ hubs.ly/H0nshRF0
