This paper reviews 25 cases of death in Wuhan University Peoples Hospital from January 14 to February 13, 2020, and analyzes their clinical records, laboratory test results, chest X-ray or lung CT results. The results showed that the average age of the dead was 71.48 years old and the average course of disease was 10.56 days. All patients died of respiratory failure, which indicated that the lung was the main target organ of the new coronavirus.
In this study, PCT (procalcitonin) levels increased in 90.5% of patients. PCT is a diagnostic index of bacterial infection. The results show that bacterial infection may be an important factor to accelerate the death of patients. In addition, the proportion of CRP (C-reactive protein) and SAA (serum amyloid A) increased before death was 85% and 100%, respectively. CRP is an inflammatory marker, which plays an important role in host defense against invading pathogens and inflammation. SAA is a plasma protein, which transports lipids in the process of inflammation. These two indicators showed novel coronavirus pneumonia patients died of severe inflammatory cascade.
General clinical features of 25 dead patients: all of them have basic diseases, including 16 cases with hypertension, 10 cases with diabetes, 8 cases with heart disease, 5 cases with kidney disease, 4 cases with cerebral infarction, 2 cases with chronic obstructive pulmonary disease, 2 cases with malignant tumor, and 1 case with acute pancreatitis. All of them are medrxiv graphs
A1 and A2, B1 and B2, C1 and C2 were the early and late chest CT scans of three patients respectively
The novel coronavirus pneumonia is the most common organ damage in lung and heart, followed by kidney and liver. The novel coronavirus pneumonia is the most important risk factor for death in patients with new crown pneumonia. Besides, bacterial infection may also be an important factor to accelerate the death of patients. Malnutrition is common in critically ill patients.
For novel coronavirus pneumonia patients who died of respiratory failure in the study, Gong Zuojiong, a correspondent, told DeepTech deep technology interview that these patients were suffocated because there was a lot of mucus in the lungs, oxygen could not enter the alveoli and gas exchange, oxygen absorption could not be absorbed, and finally suffocated. The course of the disease is related to many factors, including the way and timing of respiratory support, early warning, and of course, the severity of the underlying disease. Now we need to establish an early warning evaluation system, so as to be able to intervene earlier and more actively, so as to reduce the mortality rate.
The novel coronavirus novel coronavirus pneumonia and respiratory failure were diagnosed as clinical death causes. The same findings were also reported by Professor Liu Liang of the Department of forensic medicine of Tongji Medical College of Huazhong University of Science and Technology and his teams anatomy of the dead body of the new crown pneumonia.
A novel coronavirus pneumonia death was reported by Liu Liang team in the Journal of forensic medicine. The report is a systematic autopsy observation.
The research team pointed out that the lung injury of the dead was obvious, the lung was patchy, gray white focus and dark red bleeding were seen, and a large number of thick secretion overflowed from the alveoli in the section, suggesting that the new coronavirus mainly caused the inflammatory reaction characterized by deep airway and alveoli injury.
The novel coronavirus was diagnosed as novel coronavirus on the thirteenth day after admission. The novel coronavirus pneumonia and respiratory failure were diagnosed as the cause of clinical death on the 28 day after admission.
Novel coronavirus pneumonia has a prominent feature: mucus in the small airway is very high, and the viscosity is very high, which obstruct airway patency, which causes secondary infection and more serious. Novel coronavirus pneumonia was a major research topic in February 27th. At the February 27th Guangzhou Medical University held the special news briefing on epidemic prevention and control, Zhong Nanshan, senior member of the National Health Protection Committee and academician of China Academy of engineering, mentioned that in the new crown pneumonia, mucus removal in small airway is an important research object.
The data of pathological anatomy of 11 cases were released quickly, which is valuable for clinical guidance
Wang GuiQiang, director of the Department of infectious diseases, the first hospital of Peking University: there are 11 patients with pathoanatomy. The preliminary results have guiding value for clinical practice. There is a lot of work to do in case anatomy, and pathologists are discussing the results with clinical experts. The data should be reported soon for important reference of clinical treatment decision-making.