71 例新型冠状病毒肺炎死亡病例的临床特征

Objective: To provide a basis for the early identification and treatment of severe and critical coronavirus disease 2019 (COVID - 19) by analyzing the clinical characteristics of the death cases. Methods: We retrospectively analyzed the clinical characteristics of 71 COVID - 19 cases which died during hospitalization. The clinical data included general data, underlying disease, clinical manifestation, biochemical laboratory examination, imaging examination, complications, and treatment, then the influencing factors of in - hospital survival were analyzed. Results: Most of the 71 patients were ≥60 years old (78. 9%) and had underlying diseases (74. 6%), in which hypertension ranked first, and fever was the most common first symptom. Biochemical laboratory tests showed that D-Dimer and C-reactive protein maintained at high levels during hospitalization, and lymphocyte count declined. Leukocyte/neutrophil counts, neutrophil to lymphocyte ratio, procalcitonin, creatine kinase, and lactate dehydrogenase increased. The main imaging features of the dead cases were the multifocal ground glass changes and consolidation of the lungs. The most common complications were acute respiratory distress syndrome (89. 9%), shock (34. 3%), and acute myocardial injury (30. 4%). 90% of the patients received auxiliary ventilation, and the decrease of blood oxygen saturation and the increase of procalcitonin may be the risk factors for shorter in-hospital survival. Conclusion: Severe and critical COVID-19 patients show different characteristics in clinical manifestations, biochemical laboratory examination, imaging examination, complications, and treatment reactions, which need early identification and treatment, and bewaring of acute respiratory distress syndrome and multiple organs failure.