Being of an older age, showing signs of sepsis, and having blood clotting issues when admitted to hospital are key risk factors associated with higher risk of death from the new coronavirus (COVID-19), according to a new Lancet study. The new study of 191 patients with confirmed COVID-19 from two hospitals in Wuhan, China, is the first time researchers have examined risk factors associated with severe disease and death in hospitalised adults.
On average, patients were middle-aged (median age 56 years), most were men (62 per cent, 119 patients), and around half had underlying chronic conditions (48 per cent, 91 patients) — the most common being high blood pressure, and diabetes.
In the study of 191 patients, 137 were discharged and 54 died in hospital. Compared with survivors, patients who died were more likely to be older (average age 69 years vs 52 years). In addition, new data indicate that the median duration of viral shedding was 20 days in survivors (ranging from 8 to 37 days), and the virus was detectable until death in the 54 non-survivors.
While prolonged viral shedding suggests that patients may still be capable of spreading COVID-19, the authors caution that the duration of viral shedding is influenced by disease severity. “The extended viral shedding has important implications for guiding decisions around isolation precautions and antiviral treatment in patients with confirmed COVID-19 infection,” explained co-lead author Professor Bin Cao from the China-Japan Friendship Hospital and Capital Medical University, China
However, “We need to be clear that viral shedding time should not be confused with other self-isolation guidance for people who may have been exposed to COVID-19 but do not have symptoms, as this guidance is based on the incubation time of the virus.”