Hospitalization and Critical Care of 109 Decedents with COVID-19 Pneumonia in Wuhan, China

Ann Am Thorac Soc. 2020 Jul;17(7):839-846. doi: 10.1513/AnnalsATS.202003-225OC.


Rationale: The current outbreak of coronavirus disease (COVID-19) pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China, spreads across national and international borders. The overall death rate of COVID-19 pneumonia in the Chinese population was 4%.Objectives: To describe the process of hospitalization and critical care of patients who died of COVID-19 pneumonia.Methods: This was a multicenter observational study of 109 decedents with COVID-19 pneumonia from three hospitals in Wuhan. Demographic, clinical, laboratory, and treatment data were collected and analyzed, and the final date of follow-up was February 24, 2020.Results: The mean age of 109 decedents with COVID-19 pneumonia was 70.7 years, 35 patients (32.1%) were female, and 85 patients (78.0%) suffered from one or more underlying comorbidities. Multiple organ failure, especially respiratory failure and heart failure, appeared in all patients even at the early stage of disease. Overall, the mean time from onset of symptoms to death was 22.3 days. All 109 hospitalized patients needed admission to an intensive care unit (ICU); however, because of limited availability, only 51 (46.8%) could be admitted. The period from hospitalization to death in the ICU group and non-ICU group was 15.9 days (standard deviation = 8.8 d) and 12.5 days (8.6 d, P = 0.044), respectively.Conclusions: Mortality due to COVID-19 pneumonia was concentrated in patients above the age of 65 years, especially those with major comorbidities. Patients who were admitted to the ICU lived longer than those who were not. Our findings should aid in the recognition and clinical management of such infections, especially with regard to ICU resource allocation.

Keywords: COVID-19; SARS-CoV-2; mortality; pneumonia.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Betacoronavirus* / isolation & purification
  • Betacoronavirus* / pathogenicity
  • COVID-19
  • China / epidemiology
  • Comorbidity
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / physiopathology
  • Coronavirus Infections* / therapy
  • Critical Care / methods*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Male
  • Mortality
  • Multiple Organ Failure* / diagnosis
  • Multiple Organ Failure* / etiology
  • Outcome and Process Assessment, Health Care
  • Pandemics*
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / etiology
  • Pneumonia, Viral* / mortality
  • Pneumonia, Viral* / physiopathology
  • Pneumonia, Viral* / therapy
  • Prognosis
  • Respiratory Insufficiency* / etiology
  • Respiratory Insufficiency* / therapy
  • Risk Assessment
  • Risk Factors
  • SARS-CoV-2